Excellent thread--

I learned about this death spiral years ago since we have always had to carry our own individual policies.

It is MUCH WORSE with some companies. I think we went through 3 or 4 of them (John Alden was 1)

About 8 years ago we switched to Blue Shield and they have been better. They still play the same game--
premiums go up and you have to switch to a different group to get the very lowest rates, but it's not
as dramatic as it was with the others.

Oh and, anyone who would like the California AB1672 brochure that my brokerage produces is welcome to request it. It is one page and it will explain in concise easy-to-read language why thousands of Californians who would otherwise not qualify for health insurance can get it.

TYTBUDGET

SUCKISSTAPLES said:vampyr said:As a self-employed person there are very few options; sometimes none. You have to join a trade or professional association to have access to true group insurance as a self-employed person.

I joined IEEE and AICPA just to gain access to their benefits, and no Im not in either field.

time for an updated Professional association thread?

Very nice. Some employers will also pay for your membership in these professional associations. Years ago I became a memeber of ACM this way. Then again, if you are an employee you probably don't care about buying insurance (maybe you should though).

So to summarize all this info - and please correct if wrong. To be covered but also fatten your wallet you should:

1) If you are healthy, start with a very low cost individual insurance policy (ehealthinsurance.com, and goldenrule.com seem to be the best internet places to start your search). You buy this policy knowing full well that if your health deteriorates you will be changing policies.

2) If your health deteriorates, sometime before your premium is jacked up, plan on joining a group policy though a professional association (see the thread linked above) or your local chamber of commerce.


Now what about employees who are covered by their employers expensive plans but offered incentive to opt out of that plan? I guess the above could apply to them also - if it makes financial sense, drop your employer's plan, get an individual plan, and if your health deteriorates consider either going back into your employers plan or joining another group plan.

I've had individual health insurance (a family plan) with Golden Rule for the last 8 years. The company has been great with timely filing of claims, reimbursement, etc. No complaints, no hassles. Having said that, our premiums for a family of 4 have increased from less than $300 a month to almost $900 a month over that time and we vountarily increased our deductible from $2,500 to $5,000 a year in order to keep premiums down. My son has a chronic health condition that was diagnosed since we got Golden Rule and we are stuck regardless of how much the premiums cost. HOwever, if you're looking for an indidvidual health plan, I recommend Golden Rule, based on my family's experience.

MarketVViz said:So to summarize all this info - and please correct if wrong. To be covered but also fatten your wallet you should:

1) If you are healthy, start with a very low cost individual insurance policy (ehealthinsurance.com, and goldenrule.com seem to be the best internet places to start your search). You buy this policy knowing full well that if your health deteriorates you will be changing policies.

2) If your health deteriorates, sometime before your premium is jacked up, plan on joining a group policy though a professional association.

Only problem with that is , Depending on the underwriting of the professional association coverage, it may be too LATE to wait till health deteriorates to switch

SUCKISSTAPLES said:MarketVViz said:So to summarize all this info - and please correct if wrong. To be covered but also fatten your wallet you should:

1) If you are healthy, start with a very low cost individual insurance policy (ehealthinsurance.com, and goldenrule.com seem to be the best internet places to start your search). You buy this policy knowing full well that if your health deteriorates you will be changing policies.

2) If your health deteriorates, sometime before your premium is jacked up, plan on joining a group policy though a professional association.

Only problem with that is , Depending on the underwriting of the professional association coverage, it may be too LATE to wait till health deteriorates to switch

True group insurance has HIPAA rules-- this means that nobody can be turned down or charged more based on health conditions; one can only be charged more based on age and chosen deductible limits.

Rules must apply equally to all. There can be time-limits on when one is eligible within the association to obtain the insurance- typically two years of membership is required. Also, if one doesn't have previous creditable health insurance, there will be a pre-existing conditions limitation for up to 12 months. If one has longterm individual health insurance, this will eliminate the pre-existing condition limit in most cases when one switches from an individual to a group plan.

SUCKISSTAPLES said:time for an updated Professional association thread?Yes, please!

Help is on its way

DWebb said:He was diagnosed about 6 years ago, so about 2 years after we started with Golden Rule. We've applied for other plans and been denied, but then, after learning the "rules," started just flat asking on the phone if they would take him. They just tell us not to even apply, because they won't accept us. I lived in NYC for several years ago and they are one of the few states that are required to accept you, no matter what, provided you can afford the premiums. (that was before his diagnosis, but I was still on an individual policy, so learned about how the system worked there.) And, NYS also (or at least used to) have individual HMO plans, which were less expensive. We were enrolled in one of those when we moved. Those are nonexistant in Texas, where I now live. The health risk pool in Texas is an option, but it's no cheaper than keeping him on our individual plan (at least at this point in time). We'll just keep paying until we can't afford to anymore. And we worry how he will be covered, once he's out on his own.

If you work in engineering or computer fields, consider joining IEEE. After two years, you can get group insurance. While IEEE seems lax at the moment in checking applications for general membership, I think it's risky to join for the purposes of the insurance without meeting the qualifications, as they might do so someday, at least for those utilizing the insurance. One cannot enroll in IEEE health insurance at the moment, but I suspect that's because they're changing providers in January.

There seems to be a big disconnect between what different people have been saying in this thread and I would really like to get to the bottom of it. Some say that under HIPAA, you cannot be denied group insurance for pre-existing conditions. This would imply that you should be able to get into any group insurance (for example, from an employer, from a spouse's employer, from a professional organization, from a local chamber of commerce, etc.) - have you tried getting into a group policy? This is the KEY issue for me (and I assume for most people considering individual health insurance). Note - if, as you have said, you are paying $900/month + a $5,000 deductible, and your son's cronic condition leads to maxing out that deductible, we are talking over $15,000/year that you are currently spending on health insurance, that seems like a pretty big incentive for either you or your spouse to get alternate coverage if its possible.


DWebb said:He was diagnosed about 6 years ago, so about 2 years after we started with Golden Rule. We've applied for other plans and been denied, but then, after learning the "rules," started just flat asking on the phone if they would take him. They just tell us not to even apply, because they won't accept us. I lived in NYC for several years ago and they are one of the few states that are required to accept you, no matter what, provided you can afford the premiums. (that was before his diagnosis, but I was still on an individual policy, so learned about how the system worked there.) And, NYS also (or at least used to) have individual HMO plans, which were less expensive. We were enrolled in one of those when we moved. Those are nonexistant in Texas, where I now live. The health risk pool in Texas is an option, but it's no cheaper than keeping him on our individual plan (at least at this point in time). We'll just keep paying until we can't afford to anymore. And we worry how he will be covered, once he's out on his own.