Health Insurance after Job Loss
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May 2005
My spouse is about to start out on his own career track,
leaving his job & our health insurance behind. We need to
find a new insurance plan for 2 adults and 2 kids. There
may be a pregnancy in my future, so I'd like to find a plan
with excellent prenatal coverage. I don't want to change
doctors, so I think I want a PPO. Does anyone know where I
should look to find a new plan? I checked the website but
didn't find any recommendations.
Anon.
You might want to go on Cobra initially; you can drop dental and vision
insurance if you just want the health insurance. You can apply to Kaiser and
Blue Cross, and possibly other plans, under business insurance and save a lot
of money. You need only 2 employees on the plan and it could be you and
your husband if you help him. You can also qualify for group insurance plans
through professional groups.
anon
The most important thing is not to have a gap in your medical
coverage. Companies look harder when there's been a gap in
coverage because they assume you have unmet healthcare needs.
So COBRA first is a good idea. Nationwide has the most liberal
criteria I found in searching for individual health insurance.
You have to join the CA Farm Bureau (anyone can) and then you
can apply for Nationwide. I really like the company; they pay
claims, answer their phones with live people and have CCN as
their provider network, and that's huge! Good luck!
Joanna
August 2003
My husband recently left his job. The COBRA option is
ridiculously expensive for our family of 5. Does anyone have any
recommendations of how to go about researching private health
insurance carriers or which ones are worth checking out - which
ones to avoid? We are open to HMO or PPO. Thank you.
N
Health insurance is an expensive proposition. I try to help my
patients make a decision like this: You buy homeowners or
renters insurance for much less money than most people pay for
medical insurance, but you don't expect the homeowners insurance
to cover replacing lightbulbs. You have that coverage for
catastrophic needs like a fire or robbery. If you are the
average healthy family, you do not utilize 5-10 thousand dollars
per year of medical care, so why would you want to pay premiums
of that much, just to avoid paying for the occasional doctor's
visit?
My recommendation is that you look for a PPO plan which allows
you freedom of choice of your providers and hospitals (although
your copay may change for our of plan providers)and has a high
family annual deductable. A healthy family is hard pressed to
spend even the highest deductible of $4500 per year on medical
care, and your premiums can be low because you are not asking
the plan to 'pay for your lightbulbs'. However, in the
circumstance that there is surgery required or some other
serious illness, you have coverage for this catastrophic event.
Some of these plans also allow you to save money in a tax
deferred account called a medical savings account. It earns
interest tax deferred, and can be used to pay medical bills.
With many of these plans, if your saved money is not used for
medical bills by the time you reach retirement age, it can be
used for retirement also.
A good plan which has both of these options is the Blue Shield
MSA plan. I purchased mine through a broker called Jim
Fleming. You by no means need to contact him, but he is
constantly reviewing insurance plans, and has the most up to
date information, so he does the shopping around for you. His
phone # is 925 891-3000
I highly recommend putting the majority of what you would pay
for premiums for a low co-pay plan into an MSA. Why pay
premiums for what you hopefully will never use anyway?
Good Luck
elizabeth lee
I am in a similar situation and found that Kaiser is about half
what our COBRA would be: $527/mo for a family. Still steep but
much easier to handle. I have been on Kaiser before and found
it to be fine if you can advocate for yourself.
jen
my husband and i are self-insured. we have the blue cross PPO plan. i
did a lot of shopping and comparing to find it and worked through a
broker (who unfortunately is no longer practicing). i highly recommend
the experience of working with a broker -- saves you time and money in
the end (you pay nothing; they get commissions from the HMOs). i know
quite a few families who find the blue cross PPO to be affordable
(comparatively speaking, i suppose) for them. alternatively, depending
on the situation, the blue cross HMO can sometimes be more cost-
effective. although they are as irritating to deal with as any managed
care organization, you can sometimes get a good counselor on the line
with customer care who will work the numbers for you and figure out
which plan would be most appropriate. in some cases it seems that
people with children do better on the HMO. hope this helps.
Kim
One way to inverstigate health insurance is to call a broker.
Brokers get paid by the health insurance companies, so it is
good to find a broker that works with several different
companies to make sure that they are truly recommending the best
plan for you and not the plan that gives them the most
commission. Brokers are also helpful because, assuming you find
a good one, they are often familiar with the plan specifics and
can help you if any questions arise on your plan.
A broker that I would strongly recommend is Carman Insurance
Services. They are located in North Berkeley and it is a husband
and wife team, Andy and his wife Dawn. I have briefly worked
with them, both as an employee and also years later when they
helped the small business that I worked for. They are very
involved with all of the companies they help, and they
specialize in small businesses and personal insurance. Their
number is 528 4781. Feel free to say mention you got their info
from me.
Good luck figuring out all the confusing health insurance stuff!
~Nicole
May 2003
I am coming from a country where everybody is covered by
health insurance and I am very shocked that a rich country
like the U.S doesn't see it as important to cover everybody.
Right know my husband has a pretty secure job and me and
my daughter are covered under his insurance. I am just
wondering what would happen if he would get very sick to
the point that he couldn't work anymore. How does health
insurance at your work help you in this case ? Do they still
cover you for years if you would have cancer for example ? If
he would buy private insurance how would he come up with
the money if he doesn't make any. I made only 250000
Dollars a year before I stayed home with our daughter so I
couldn't pay for it either. I did have health insurance at my
old job but I just went with my husbands health insurance.
When I start working again should I sign my husband and
daughter also under my health insurance just in case
something horrible happens to him. I am very confused
about this whole issue. I would be very thankful for any
advise.
Yes, it is amazing that health insurance is not a given in the
US. If your husband were to lost his job for some reason, you
could keep the insurance for up to 18 months (COBRA), but would
have to pay for it yourself. Often, an exorbiant sum. For our
family of three, it would be more than our mortgage each month!
Many people switch to high deductible or catastrophic coverage,
or try something like Kaiser, a lower-cost HMO that people seem
to either love or hate. If you have any sort of pre-exisiting
condition (such as asthma, a disease you have recovered from, or
the insurance company just doesn't want to cover you) then you
might run into trouble. The state of California has some very
weak coverage for people like this, but it also has a very long
wait list.
My recommendation to you is to hope that you can keep coverage
through your husband's work. If for some reason that falls
through, you can always get a part-time job at a place like
Starbucks and get great coverage for your family (lots of moms
do this!), or find a full-time job that covers you all.
Also...State Senator Perata is trying to pass two bills (I
believe one is SB921) to help with this very situation. You can
find out more about them and ***voice your support*** via
Capitol Office State Capitol Room 4061
Sacramento, CA 95814
Phone (916) 445-6577
District Offices 1515 Clay Street, #2202
Oakland, CA 94612
Ph (510) 286-1333
e-mail Senator.Perata@sen.ca.gov
http//democrats.sen.ca.gov/senator/perata/
Another site that covers this issue is
http//votehealth.net/articles/sb921.html
--advocate for affordable, quality health care for all
April 2002
My husband's just lost his job and with it our benefits, and so
we're looking into various options for paying for our own health
care. COBRA is hugely expensive, so that's not an option. One
thing we're considering is buying catastrophic health coverage
for the family and paying for our routine care out-of-pocket.
I'm wondering if other families have done this, and how it's
worked for them. What are the pros and cons? Who did you buy
catastrophic from? Did you use a Medical Savings Account? And,
if we do decide to buy our own health insurance, what health
plans -- in addition to Kaiser -- have affordable options for
people buying their own insurance?
nelly
I don't know whether you want to stay with your current doctor(s) or not, but you can see an instant quote
for Kaiser Permanente's Personal Advantage plan at:
https://ehealthplan.kp.org/ApplyOnline/index.html
Good luck!
- Sharon
I think Kaiser is a fabulous insurance plan for a family. As an example, for a family of
4, i.e., 2 kids and 2 parents in their 30's, it's about $440/month. It's comprehensive,
accessible, and I've found the physicians to be terrific. It's nice to have your provider,
your spouse's and your child's all in the same location. Everything is in their database,
no need to worry about referrals being authorized or not, etc. We've had at least 4 other
insurance plans, and Kaiser is by far, the best. We've had no complaints. It may seem like a
''factory'' at times, but I find it to be a very efficient one. They even make appointments
to specialists or other departments for you! This is unheard of elsewhere. And, if you're not
happy with your doctor, you can always change, or shop around.
just my two cents. Good luck. Even $440 is a lot of money, so it's important to be happy.
Anon.
When I researched this two years ago, the cheapest plan I could find was Kaiser which is an HMO. As a family of four, with the main subscriber in her mid-thirties, we are paying $440/month. Our co-pay is
$15 per office visit. Kaiser can be great if you know how to work the system. They have great doctors,
although it can be hard to find good ones taking new patients. After years of being with Kaiser, I still
haven't found a primary care provider for my husband and I, although we are very happy with the kids'
pediatrician.
Daphne
I've had good luck with an MSA -- a medical savings account designed for self-employed people. Blue Shield offers a high-deductible, low-premium plan that works with an MSA (based on my research, I'd say they're the only MSA-compatible health plan worth having in CA). Basically, the account (I got mine through Merrill Lynch) is a tax-deferred savings account for medical expenses. You can get any vehicle you want - mutual fund, money market, etc. They give you a Visa card to use for all your expenses. It works pretty well, and helps ease the sting every April 15.
sonya
I am a self employed plastic surgeon in Berkeley, so I have examined health insurance issues from both sides. Health insurance is a problem as it is often expensive and difficult to utilize. For the average, healthy family, health care utilization usually includes annual checkups including some testing for the adults, mammograms, pap smears, blood work, etc and perhaps a few sick baby visits to the pediatrician. This in general, should cost less even if you were paying out of pocket than your premiums of $600 per month. In my opinion, the best health insurance plan out there
is a PPO plan with a high deductible and low premium cost. This would become of use in the event of an illness requiring hospitalization or surgery, and for most of us, thank goodness, that is a rare or nonexistant event. Blue Shield has some programs like this. It also has a program where you can set up a medical savings account, one which earns interest on a tax deferred basis and can be used for retirement if you have not used it for health care.
Most people out there seem to be looking for a way to pay premiums up front and then pay little or nothing to actually see the doctor. You are paying more in premiums than you are likely to ever use. This is wasted money. When you buy renters or homeowners insurance, you are insuring for catastrophic events, not to have your lightbulbs changed for free, it really makes financial sense to view your health insurance the same way.
Elizabeth Lee, MD
Both my husband and I are self-employed. I've got Kaiser and he's got Blue Cross (from before we were married). Both of us are happy with the care we get, but the big difference I can see is in price. Kaiser is much more reasonable. His premium is more than my infant son and I combined. Premiums for both of us have been going up, but while Blue Cross will jump up $50-75, Kaiser only goes up by $10-15. Blue Cross has many more out of pocket expenses, as well as a $250 deductable for perscriptions, which hits us where it hurts. I know some people have had problems with Kaiser, but I've received great care there, including having a baby. But unfortunately, for an individual plan, they may not accept people with pre-existing conditions, as was the case for my husband when we tried to switch.
Mara
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