Ask Slashdot: Health Insurance for the Self-Employed 111
A nameless submittor wanted to voice this very valid concern: "I'm a self-employed contract programmer whose COBRA benefits are going to run out early next year. I was wondering what experiences others of similar employ have had obtaining health and disability insurance? What is available? What about rates? Is the coverage any good? What do I need to look out for?"
Re:SCREW THE CANADIANS (Score:1)
Re:One thing to watch out for ... (Score:1)
You may want to consider getting some insurance with a huge deducatable to protect your parents and their finances in case something really terrible happens to you. Many parents would sell their house to pay for health care for one of their children. Thats not a decision I'd like to force on my parents.
Re:You can get your own insurance cheaply... (Score:1)
Re:general advice (Score:1)
FIRST THERE WAS KAISER...
I was covered by Kaiser Permanente when living in CA, and they were an absolute dream. I walk in, They copy down my membership number, I wait a not-unreasonable period of time, they treat me, and I leave. When I got run over by my boss on my motorcycle (another story entirely), they took care of the whole mess. I had been carted off to a local chop-shop clinic by my employer, which sewed my missing digit back on, and Kaiser had to *undo* the surgery and sew it back on correctly.
I never saw any paperwork, I never had to pay anything other than my premium, and they even packed up a bag full of dressings & other medical accoutrements for me to take on my non-reschedulable road-trip 10 days later.
AND THEN THERE WAS GROUP HEALTH...
Having been blissed-out by my experience with Kaiser, I joined Group Health in Washington State. I quickly discovered that they are (imho) expensive, paperwork-intensive, mired in referral bullshit, and generally client-unfriendly. They insisted on assigning me to a GP, and then assigned me to a team of seven GP doctors so that I never saw the same GP twice. (Kind of defeats the purpose, no?)
It was impossible to see any specialist without seeing Dr. RandomGP(N), who would defer to Dr. RandomGP(N-1)'s experience, except that I couldn't never get in to see Dr. RandomGP(N-1) again because clients are only allowed to schedule appointments with Dr. RandomGP(ANY).
When I finally did get to see a specialist about the RSI injury to my wrist... well... I had a ~0.75" fluid bubble poking out of a rupture in the muscle wall. What does the GH doctor do? He had me look away and hit my wrist with a motherf*cking book to burst it! And because I didn't flinch when he thought I would, he hit me a lot harder than intended, and had to send me in for x-rays to make sure he didn't break my wrist. (On later visits he tried cortizone injections, then finally surgery as I had requested.)
And imho I got better treatment than the average Joe because my Group Health card was green rather than blue. What does green mean to them? Cash. I was a full-cash-paying customer. Blue-card clients (work-paid-insurance), from what I could see, got treated like shit and had to wait longer, too. Me, I got to go to the front of the line and get my poor service much faster.
IN THE END
The bottom line is that every individual's experience will be different. The kind of hands-off independence that Kaiser provided for me would be perceived as poor service by someone of my parents' generation, but I couldn't stand the way that GH did business. I'm sure that there are people out there who are happy with GH's service, I've just never me t any of them. But I wouldn't take that experience and condemn all HMOs. YMMV.
Another option - UK (Score:1)
Ditto s/Canada/UK/
Free healthcare [doh.gov.uk], everything is within a day's drive (even most of Europe), ADSL [bt.com] and GPRS [gsmdata.com] are being rolled out nationwide next year, no mad people with guns (not even the police), we have strong beer and even stronger cider, you can get laid at 16 and drunk at 18, we don't have daft crypto laws, and most people are atheists.
London sucks, petrol (gasoline) prices suck (70p/litre, US$5/gallon), but other than that it's a pretty cool place to be.
I know a couple of people who telecommute to jobs in the States. Once you have remote reboot installed on your machine, being on the same continent doesn't really matter anymore.
--
NASE seems to be a sweet deal (Score:1)
For another $30/month, you get the indemnity plan which covers you regardless of where you are, etc.
Also, NASE plan has the best vision plan I've ever had. My vision plan history was:
Andersen Consulting: jack shit
Informix Software: crappy voucher based system - some decent savings
Houston Chronicle: jack shit
SELF-EMPLOYED BARNEY BADASS: free lenses and eye exam, 60% off of frames (even fancy schmancy ones), 40% off of extra crap (coatings, etc.)
Not to imply that
WG
Re:Another option - UK (Score:1)
Newcastle is the best place to live in the UK, FWIW. It has everything you need and much better than London. If you need to get to the capital there's plenty of trains and planes serve the area frequently. Newcastle has been voted the party capital of the UK and the best place to work in the UK.
On the subject of healthcare it should be free in every country as it is so important. We do have private healthcare in the UK for those with money and want to have extra benefits but free healthcare is available to all however rich or poor you are.
The only exception that I know of is road accidents. In this case the person who is responsible for the crash has to pay for the hospital bills (but by law they have to have insurance for this).
Petrol is dear, and public transport in most of the UK is crap. In London it's overcrowded. That's another reason why Newcastle is cool as it has decent public transport and fairly cheap beer.
The cost of living in the north is cheaper than in the south (I know I'm in London now and can't wait to get back to Newcastle).
--
A side job (Score:1)
A option (Score:1)
As an added bonus, moving to say Toronto or Ottawa, you get cheap DSL or cable modems, and pretty good cable TV (59 channels 30 bucks)..
There is also that whole clean, polite, non-gun carryingness thing... I live in city with over a million people, (Ottawa) there is about 3 murders a year and maybe 5 non-domestic violent crimes.. I like them odds..
Downsides would definitly be the weather (compaired to Silicon Vally) and the taxes..
Vancouver gets you out of the snow, but you get rain instead.. Taxes are what they are, take it or leave it I guess..
Don't want to start a Canada rules/sucks thread, but if I was a self employed geek in the US, I'd at least figure out what it would cost me tax wise if I relocated north..
One other perk, no drug tests..
Great green north and all that..
Re:Canadian medicare (Score:1)
The rest of the first world laughs it smug ass off at the big ol' US.. "How can they call it a civilized nation if you can die on the street because you can't afford a doctor.." is the general comment.. Seems like a valid point to me..
The US of A: Booming economy, goverments books in pretty good shape, world strong superpower, and its poor dieing on the steets every day, how nice..
Re:An option (Score:1)
Northern Quebec is probably about as bad as it gets.. It's basically the Canadian version of the deep south..
Re:Another option - UK (Score:1)
Amsterdam is like Las Vegas for stoners, and has a raging newmedia industry to boot.. A little more school, and I'm off.. Last time I was there I was tempted to just drop out now and start selling DSL to all the internet cafes..
18,000 feet covers alot of ground in the old world.. One NOC in downtown amsterdam would have no problems making money off all the bars/cafes inside loop range..
Not to mention, normal old unix admins are seriously in demand, speaking dutch totally not required..
Get catastrophic coverage (Score:1)
One suggestion-- Ask your doctor (Score:1)
Join a professional organization! (Score:1)
When I was living in California, I used Blue Cross, which was fairly reasonable (~$130/month, and I was about 33 at the time).
Here in New York, insurance is a *lot* more expensive. I'm currently getting coverage through the National Writers Union at $277/month.
Others have pointed out that IEEE has insurance - so does the ACM, and if you're a hacker with a degree or have been in the field for a while, it's easy to join and includes some other useful bennies as well.
Re:Coverage in Massachusetts (Score:1)
We are currently using united healthcare PPO plan and spending something like $500-$600 per month for family coverage. This includes $15 co-pays on office visits and $10 co-pay on drugs.
we have had some small hassles with them but usually, if you're a persistent pain in the butt, they pay.
Disability insurance is a whole different story. Individual rates are extremely high and if you have anything even vaguely wrong, forget about coverage. I'm living with an RSI based disability and I can't get coverage even excluding my RSI.
So, I self-insure. Save as much money as possible and don't forget the corporate shield (you did incorporate as an S-corp?).
good luck, and start bribing your Congress critter to eliminate health insurance as a tax deduction for corporations!
Re:Get a policy through IEEE (Score:1)
but I do have term life, and just applied for
disability. The rates on all their insurances
are very low, and they offer almost all types
of insurance.
The journals (most available online now!) from
IEEE are also an awesome source of info, so you
do get something else out of the yearly membership
fee.
Re:Get a policy through IEEE (Score:1)
but I do have term life, and just applied for
disability. The rates on all their insurances
are very low, and they offer almost all types
of insurance (incl home and auto, I believe).
The journals (most available online now!) from
IEEE are a good source of industry info and
research, so you do get something else out of
the yearly membership fee than cheap insurance.
Re:Coverage in Massachusetts (Score:1)
Coverage in Massachusetts (Score:1)
One more datapoint.
Just move to civilization... (Score:1)
-- ----------------------------------------------
Vive le logiciel... Libre!!!
upstate new york (Score:1)
Re:Get a policy through IEEE (Score:1)
Now, they probably want to you *staying* a member...
Re:WHAT IS COBRA - read on (Score:1)
Congressional
Omnibus
Budget
Reconciliation
Act
and is a federal statute, not a state one. I certainly made use of it here in Minnesota.
Regards,
JFB
One thing to watch out for ... (Score:1)
I gambled and lost, shedding COBRA and benefits in exchange for mucho dinero, and, as fate would have it, a sprung achilles tendon.
If you think that, say, a shit-hot Oracle kernel engineer makes big bucks, just wait until the bill from the anestheologist's office arrives. $3500 for forty minutes of work
I'd make the same sacrifice again, but I'm single and without dependents. How you approach the issue is almost wholly dependent on your specific situation.
Good luck,
JFB
Are you an IEEE Member? AWESOME INSURANCE! (Score:1)
If you are an IEEE member, you can sign up in their open-enrollment period this January. Rates are typical of a business that is 300,000 employees, only you pay 100%. But it is still MANY TIMES BETTER THAN YOU ALONE!
Even if you don't go for the medical, the Life Insurance is a no-brainer! Definately check out Life regardless!
Re:Opinions on NASE? (Score:1)
But it got worse. I never found it necessary to make a claim in that year. However, inside 6 months, the rates were hiked to $100 per month. Hmmm, I thought. Time to shop around. By the time they hiked to $135 per month, I decided it was definitely time to bail. I was back in school by that point, and used BYU's health plan (fairly nice to single students).
MEGA (the insurer of the NASE plan) said the cost increase was due to rising medical costs. %100 in 1 year? I think not.
Health Care for OSS (Score:1)
As a poor college student, $80 (although cheap for health insurance) is still a lot of money when you concider all I shell out a month in rent and beer.
Has anyone given any though to starting our own national health insurance benefits program for those of us who are in these sorts of situations? Self employed, partly employed but no benefits, would like to do nothing but code but have to do the 9 to 5 to get the benefits. We all fit some where in to this sort of a situation.
I would like to think that the community that was able to take a small time operating system written by a college student would be able to pool it's resources and come up with somehting ingenious.
----
"War doesn't determine who's right, just who's left"
general advice (Score:1)
If you look for coverage against major costs, and pay doctor's visits out of pocket, it's a good deal cheaper.
Re:Another option - UK (Score:1)
When I lived in South Wales, there was a pub near where I lived and a school across the road - quite frequently when you went in the pub during the day it was full of people in school uniform.
Generally sixth formers (school kids between 16 and 18) don't wear uniform, so that kind of suggests that the pubs daytime clientelle were, somewhat ignorant of the letter of the law.
WONDERFUL
From a Geek who once sold Health Insurance. . . (Score:1)
Caveat
This is for US types only, can't comment on Canada, UK, or elsewhere. . .
Re:An option (Score:1)
This may be different in larger cities (or in different provinces), but even so - like the tech industry, the medical industry is seeing a lot of Canada->US brain drain, so the situation is bound to worsen with time.
Re:I use Blue Cross -- ?PPO? (Score:1)
Re:general advice (Score:1)
I use an HMO, and have been very happy with it (even though I am diabetic, I have no other health problems).
The only problems I've had have resolved around seeking coverage when travelling. The rules are fairly restrictive, and claim payment has taken too long at times.
Otherwise, it's been great and economical.
Re:One suggestion-- Ask your doctor (Score:1)
Also, some states require a doctor to mention more than one company (much like if you ask your local bell company what long distance carriers are available). So, legally, he might not be able to come right out and say: "Pick XYZ PPO. They're great."
Good luck getting decent rates. With the consolidation of insurance carriers, rates are getting worse (and reimbursement is going down).
From a purely cost-benefit POV, check out the HMOs. As long as you have a good relationship with your primary care physician, you'll not have much trouble getting the *needed* specialty care. At the office I manage, we have three full-time people whose jobs are to make sure referrals get through and our patients don't pay beyond their co-pay.
If you have a chronic illness that requires specialty care, make sure your PCP and specialist are in the same HMO. Also check out eye care benefits. Most of the benefits are garbage, requiring you to go to an optometrist for primary eye care rather than an opthamologist. YMMV, but with a family history of diabetic blindness and glaucoma, I'm going to an opthamologist.
Good luck.
-George
(that's olg.com)
Insurance for the Self-Employed (Score:1)
I would never take a job where I could not get benefits, unless my wife's job was able to provide good quality benefits. I would say check out a part time job or something, because you don't want insurance for self-employed people.
No problems here! (Score:1)
Paranoid suggestion #1: be sure to pre-pay the first month and get the cancelled check *before* the switchover. Just in case there's a claim that there was some sort of "gap" in the coverage, you have your proof that there wasn't.
Happy Ending #1: I actually had an operation in the last few days of COBRA coverage, followed by recuperation in the first few days of regular coverage. There was never even a hint of problems, service denied or delayed, or extra bills or paperwork.
Re:Just move to civilization... (Score:1)
You can get your own insurance cheaply... (Score:1)
Re:Health Care for OSS (Score:1)
Try Professional Societies (Score:1)
Try professional societies, or local HMO/PPO (Score:1)
As I move more toward independent consulting (as opposed to W2 contracting), I am looking at getting an IEEE professional liability coverage plan.
CORBA? (Score:1)
Blue Cross varies state by state (Score:1)
Too many stories from other small business owners about the insurance carriers just ignoring those potential customers they don't want to deal with.
Next time around we'll look much closer at going in with some group coverage like IEEE.
Re:NASE seems to be a sweet deal (Score:1)
Do what I did, marry a nurse. The hospital has excellent health benefits, and it's dirt cheap.
-TT
Re:Coverage in Massachusetts (Score:1)
In general, the self-employed can only take a partial deduction for medical coverage. However, with an S-Corp this only applies to coverage for owners of the firm. This gives two ways to get full deductibility, at least for married people:
let E be the Entrepreneur who runs the business, and
let S be E's spouse.
1. E owns the business, which employs S and provides family medical coverage, thus covering E indirectly, or
2. S owns the business, which provides coverage for E.
Talk to your accountant if you are interested in using one of these methods.
(Aside: We used NASE for a year, and I got a bad feeling about it. The salesman said 'no paperwork' and no hassles for coverage. We didn't have any major medical problems and therefore did not reach the deductibles, so I didn't find out about coverage hassles, but the paperwork was a chore. When they said 'no paperwork' they meant 'no paperwork from us', so I had to deal with bills from each medical provider, sometimes months after the date of service. We're now with Harvard Pilgrim's POS plan, which is more expensive but easier to deal with.)
What is your situation? (Score:1)
For me, all I wanted was something that would cover me in major medical expenses. I had to pay out of pocket for doctor visits and prescriptions, but anything over about $1000 was covered. What this allowed me to do was avoid a situation where I would be bankrupted by one large medical bill. But, little thing I had to cover. The advantage was it was under $100 a month . . .
So you need to asses your life (do you have kids, are you married, etc.) and figure out what kind of coverage you need. I would definetly reccommend what I did if you are in a similar situation. I never really go to the doctor, maybe once a year tops, so the out of pocket expenses are negligible.
Also look into a 125k plan. That's a medical expenses savings plan that is taken out as pre-taxable income. Then you can use this 'savings' account to pay for any out of pocket medical expenses that aren't covered by the insurance plan you get. OF course if you don't use the money, you lose it, but you can use it for all kinds of stuff if it's getting to the end of the year (glasses, contacts, massages
Hope that helps . . .
Get a policy through IEEE (Score:1)
policy. A co-worker of mine had a nice PPO policy
through the IEEE. It was basically the same policy as was provided by our employer. You need
to be a member of IEEE, but there are other benefits such as lower conference fees and book
discounts which make the membership fee worthwhile. It's likely
that there are policies available through other
professional organizations as well (ACM?).
This may even be worth doing if you have company
coverage, in order to have portable insurance. You
can usually get your employer to pay for your
outside group policy rather than theirs.
CORBA (Score:1)
...is COBRA somehow related to CORBA?
Not bad (Score:1)
I've been self employed for 5 years now. I've also graduated to running a small company which has 4 full time employees.
When I started I just went to the bank. They were very helpful at taking my money, but I also got very comprehensive medical cover. The cost was in the order of hundreds of pounds, £, but offset that against peace of mind and a years income. I also went to a financial adviser and got a number of insurance covers: for instance if I'm permanently out of work due most reasons, other than mountain climbing unfortunately, I'll receive a salary until my retirement age, at which point I'll get my pension, another company extense.
The short of it is the cover is pretty thick out there and it's really a question of finding the best deal and also making sure you're not over covered, which I was for a while. A good way to do this is through a financial adviser.
Cheers,
Re:Opinions on NASE? (Score:1)
A few years ago, a friend's wife (insured through NASE) went through a rough (and expensive) childbirth. A year later, NASE still hadn't paid up.
It doesn't matter how cheap/good the plan looks if they don't pay off.
From the comments here, talking to an independant insurance broker looks like the best idea.
Insurance brokers (Score:1)
Re:NASE seems to be a sweet deal (Score:1)
I'm very hesitant to go with this plan, because once you go off your COBRA coverage you can't go back. But I haven't seen any other plans that I would consider going with, so I'm tempted nonetheless. I guess I still want to believe there are good deals out there, even when logic tells me I should know better...
Opinions on NASE? (Score:1)
Supposedly, this plan is like a traditional indemnity plan in that there is no managed aspect whatsoever. You can go to any doctor, any where, and they will pay the entire bill. No negotiated rates. You pay a copay for each procedure, none of this percentage stuff. The agent made it sound just about perfect; they pay whatever the doctor bills for whatever you want to have done, no questions asked. I suppose there are probably limits on cosmetic surgery and such but none of this fighting with the administrators to get medically necessary care approved.
There were a few twists I didn't quite follow; something about a deductible per injury or illness, but then there was something else that covers that, and a really funky provision where you pay a little more each month, but when you reach 65 you get all the premiums you ever paid back. Huh? I suppose that assumes that you stay in their plan until age 65, and what are the odds of that...
So, anyone care to comment on experiences, good or bad? Is it really as good as it sounds? I'm very skeptical, especially since they don't have an info packet they can mail you; they send an agent to your home instead. But if it really is a good deal then I'm all for it.
Oh yea, the plan is underwritten by Mega Life and Health. They do the student health insurance at most universities, and they seem to have some traditional plans for small businesses as well. So far I haven't found much in the way of user feedback on them out there, which is why I'm asking here. The plan they offer through NASE seems to be different from all their other offerings, anyway.
Re:Get a policy through IEEE (Score:1)
low-overhead contract firms (Score:1)
The benefits are obvious. Detriments? Not a big bench, plus you might have to beat the bushes for quality assignments and gigs.
Not bad, and it suits my lifestyle. Unfortunately I tend to be too absent minded to keep up with little details such as TAXES and INSURANCE PAYMENTS.
Seriously, though, going with a low overhead firm isn't going to shut any more doors than being independent will.
Mojotoad
Re:Health Insurance for the Self-Employed (Score:1)
I've also been on the NASE plan through my job (very small company) but nothing ever happened to me so I didn't use it...
Re:Canadian medicare (Score:1)
Re:NASE (Score:1)
Health Insurance (Score:1)
You smoke?Forget good rates or maybe even getting insured at all.If they take you your rates will be really high.Smokers are BAD.
Getting insurance on your own because you are selfemployed in a real feat.Move very slowly and read the fine print carefully.Some insure you for High deductables or for EACH sickness or injury.
Good Luck now you will see how good you had it being insured by your emplyer.
Service Companies for Freeagents (Score:1)
Healthcare insurance in the UK (Score:2)
Call Blue Cross (Score:2)
I don't know if that's a policy plan for just BCBSCT or if its something nation-wide through BCBS. Worth a shot though.
I use Blue Cross (Score:2)