Berkeley Parents Network: Low Cost Health Insurance

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Low Cost Health Insurance

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Questions

Affordable health insurance for father and son
Health insurance for family of 4, not too expensive
Health care for low-income baby
Need insurance for my 2-year-old - I make too much for Medi-cal and Healthy Families

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Affordable health insurance for father and son

Oct 2009

I am expecting my first child in March, and am looking for an affordable insurance policy for my baby (a little boy) and possibly for my husband too. We live in San Francisco. We are curious about Kaiser and would love to hear about other people's experiences with it (especially if you know about SF Kaiser). But we are also interested in perhaps a PPO. In fact, we're having a hard time deciding whether we prefer a PPO or an HMO. The whole health insurance thing is so complicated! We'd love to hear advice from those who have shopped for their own insurance (not through an employer). What companies and policies are thorough and responsible? Which should we stay away from? Are there any things we should be particularly aware of when shopping for insurance for our baby boy? Thanks for any help you can provide.

I have had to do some serious shopping around because we are now buying independantly as well. We stuck with Kaiser because we have had them and like them. They have all sort of programs to choose from. I don't know about SF Kaiser but in general I think they are great. lisa

There were several questions this week asking for affordable insurance options. For those of you that are struggling (but managing) to pay premiums, know that there are millions of people like me that are priced out of any coverage whatsoever, but make too much to qualify for medi-cal. Since it appears that our politicians are currently acting on behalf of the insurance companies, I believe that the only way the situation will change is if we make it impossible for the ins. cos themselves to continue business as usual. Therefore, I would encourage all of you that have insurance to drop your coverage in solidarity with those of use that cannot afford insurance or who have been denied coverage. Looking back on our history, major battles have only ever been won by mass action of the people. We are all in the same boat

Health insurance for family of 4, not too expensive

May 2009

We are re locating to the bay area, and need a family health insurance. I am not sure how it works, since we can not relay on a job that will provide it. Can anyone explain the different options of health insurance and recommend an insurance that is good and not too expensive for a family with 2 kids?

If you move to San Francisco, you and your family may be eligible for the city's new Healthy SF program--the income limits are quite high and you get to have a doctor, use services, etc. all for a monthly premium ($20, $50, depends on income and family size). Depending on finances, you could be eligible for some statewide programs, but the income limits on those are very tight. Otherwise, you'll be forced to call individual insurers (kaiser, blue cross, etc.) and negotiate a plan with them as a family, and that can be really expensive. anon

Health care for low-income baby

May 2007

My 6 month old daughter and I will be returning to the Bay Area (living in Fremont, schooling at UCB) this August after my being away for two years. We are both US citizens, yet Sophia hasn't set foot on American soil yet. My concern is her medical care. Can't afford to pay for it and very insecure she'll get medi-cal (as I haven't the documents they request for the application). I just need to know what there is for babies of low-income families as far as getting regular check- ups, immunizations, and care for the typical baby maladies. For instance: any free clinics?

There are a number of community clinics that you can use, regardless of your ability to pay. If you are Medi-cal eligible, the counselors at the clinic will help you in applying, and they see patients without papers all the time so can help you figure out exactly what to do.

I work for a non-profit agency that supports community clinics in Contra Costa and Solano Counties. Our website, www.clinicconsortium.org, shows all of the clinics in our area. There is a very similar non-profit in Alameda County and their website, http://www.alamedahealthconsortium.org/, lists every clinic in Alameda County. For all community clinics in California, see http://www.cpca.org.

If it turns out that you are not Medi-cal eligible, another option I would highly reccomend looking into is the Kaiser Permanente Child Health Plan. The program costs only $8 to $15 per month, depending on income, and is full-fledged Kaiser health insurance with every benefit. Check out http://prospectivemembers.kaiserpermanente.org/kpweb/healthplans/ individualplans.do and click on Child Health Plan for more information. Best wishes to you in finding health care for your family. Tara

Here are a few suggestions:

1) There are several community health centers in the Bay Area with a mission to provide health care to everyone, regardless of their ability to pay. In Oakland, you can try Clinica de la Raza or San Antonio Neighborhood Health Center. You can also try Asian Health Services or LifeLong Medical Care. (LifeLong tends to cater to older patients, but call them and they'll tell you which would be best for a baby.) All of these clinics offer a sliding scale payment structure, and your cost could be as low as $0, probably around $20.

2) Call the Alameda Public Health Department. Or go to their website. http://www.acphd.org/default.asp Public Health Depts. always offer free or low-cost vaccines, and they can point you in the right direction for a good clinic.

3) Sign your child up for Healthy Families or Medi-Cal. Your County Social Services Dept. will know how to do this. (In fact, any community health clinic will also know how you can enroll your child.) There's also another program called CHDP (Child Health and Disability Prevention Program) that your local clinics are very familiar with. CHDP will cover the costs of well-child visits. If you qualifym for CHDP (which you probably will), your baby will automatically be enrolled in Medi-Cal for two months, while you figure out the paperwork you need. If your income turns out to be too high for Medi-Cal, you will be referred to Healthy Families.

The short answer is... go to a local clinic and they'll figure out how to get permanent coverage for your baby. There are lots of resources out there. Good luck! a mom in the know about health insurance for kids

Tiburcio Vasquez Health Center is a community health center that provides excellent care. They can also help your child qualify for MediCal (vs. going through the gov't offices). http://www.tvhc.org/ anon

Lifelong Medical Care has a number of clinics in Berkeley and Oakland and their West Berkeley Family Practice sees families and kids, including those who are uninsured. Go to www.lifelongmedicalcare.org for more information. Kate

Need insurance for my 2-year-old - I make too much for Medi-cal and Healthy Families

October 2006

Does anyone know how I can get low cost health insurance for my two-year-old. She had Medi-Cal but was recently denied because I now make too much money. I tried to get her healthy families but was also denied because I made like $200 more than they allowed. Then I tried to get low cost Kaiser but I am just over their financial requirements as well. I have no problem paying for health insurance I just can't pay $400/month (as my job asks to cover a dependent). I am a single mother living in Oakland and don't get regular child support from her dad. I was planning to just pay out of pocket if she needed to go to the regular doctor's but what about if she needs to go to the hospital??? has anyone been in this situation and have any ideas about what I should do? No Health Insurance jenni

Check into a ''High Deductible Health Plan'', combined (perhaps) with a ''Health Savings Account''. With these plans you pay out-of-pocket for all minor and routine care, but get coverage in case of really expensive things.

(Note: the policy idea behind these plans is to make the costs of health care visible -- with traditional plans nobody asks for the list price of services, because it's covered. This plan option is not perfect - the HSA is a pointlessly awkward paperwork nightmare.).

With a healthy 2-year old, this type of plan could be really economical. Bryce N

Please use CAUTION if you decide to go with an HSA (health savings account). In theory, they could potentially be a good idea, but we found that the health insurance would not give us any info about procedures until after the fact, arguing that it was proprietary infomation abnd it could lead to price wars, which wasn't fair to the providers-- Oh my! It's like going to the store to but a pair of shoes, but not knowing how much they are going to cost until you have already worn them and then much later get the bill in the mail-- doesn't sound like smart shopping to me! That was with HealthNet, and we have since switched to Blue Cross (3 months ago), who does give you the $$ amount as long as you have the procedure code. It was interesting to find out when I called the health insurance commissioner's office in Sacramento that hair salons and dry cleaners are required to give you the prices for services upfront, but there is no law for health care providers (doctors, x-rays labs, etc.) to do the same. One lab snuck me the negotiated rate with Healthnet onto a slip of paper, so I could know what to expect to pay before I got my blood tests, but then had to take it back and shred it so the person wouldn't get in trouble. And...just so you know, there are wildly different prices out there. At Alta Bates Imaging my daughter got a chest x-ray for suspected pneumonia, and it cost about $200, at the insurance's negotiated rate. We needed to get her the same xray about 5 weeks later (to make sure the pneumonia was gone) and went to Children's since the other lab was closed-- we had to pay over $550 for the same exact procedure. I have since learned that ''hospitals always charge more''-- but that is a huge difference! Good luck, and proceed with caution! mad about health care in the US

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