Health Insurance for Self-Employed People
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Health Insurance for Self-Employed People
My husband is a self-employed attorney and I am leaving my job at the end of June. I
currently have Kaiser through my work and he is (gasp) uninsured and has been for
some time. We want to try to have a baby ASAP, and so need to figure out what
insurance solution will work best for our needs. To complicate things further, we
are considering a midwife or possibly a home birth. I tend to go to the doctor
frequently, and haven't always been happy with Kaiser (Oakland) and getting
referrals, although I just switched doctors and my new one seems better. I also
would like to use ''alternative'' treatments such as chiropractic, acupuncture, etc.
Some possibilities we are considering include: staying with Kaiser for me and adding
him in a limited capacity (obviously he doesn't go to the doctor much), or getting
Blue Shield PPO for me, and something with less coverage for him. Another
possibility would be a health savings account for him or both of us (Kaiser and Blue
Shield now offer these), which sounds attractive tax wise. We also will be looking
for life and disability insurance policies in the near future. We are EXTREMEMLY
confused right now and would love some help. Also, we are wondering if this is
something an insurance broker or insurance advisor might help us with, and if so,
who? We live in Berkeley. I looked through the archives for recs, and unless I
missed something, everything is a few years old. We know this is a very complex
question, and would appreciate any help!!!
confused in berkeley
In our quest for self-employed health insurance, we had a
wonderful experience with East Bay health insurance broker
Carla-Jean Barker, who has a Berkeley office and also visited our
home. She was smart, knowledgeable, warm, and caring--and found
us great deals! Her contact info is:
CJB Consulting, Inc.
CA Ins# 0D28718
--Happy insurance clients
We are a family of 5 with 3 kids under 7 including a newborn.
My husband is eager to change jobs, and this could possibly land
him in an independent contractor/self-employed situation.
But we are really concerned about what to do for healthcare; w
currently have healthnet ppo with health savings account...
His employer does pay quite a bit per month, I believe.
I am a SAHM.
Is Kaiser the best option? What have you done for
insurance/healthcare? We do not make a lot of money, and my
husband is still a student as well (so he could get care from the
university if he needs it).
How do others keep their kids healthcare going without paying
tons of money per month?
We've been self-employed for 10 years and have been with Kaiser the whole time,including
having both our kids with them. We pay about $330/mo. for a high deductible plan
(HSA-compatible plan which is new this year). I don't know if it's the best rate now,but it
was when we signed on,and we've been happy with Kaiser. The premiums will tax deductible if
you itemize. Goodl luck.
I need advice on a ''individual'' healthcare plan for when I get pregnant again. My husband is
self employed and I am a stay at home mom, so right now we have a basic PPO plan through
Healthnet, the monthly premium is reasonable, but the deductible is high. It is Ok for now as
we are in good health and I am not yet pregnant. I am looking for a plan that just I can switch
to before pregnancy, and there wont be any suprise expenses at the end.I'd like to here anyones
advice on plans that they have had..It was a lot different when I had a plan through my job.
There was no deductible and I knew what to expect when I paid my monthly fee out of my
check..Thanks for reading!
We are self-employed, have BCBS PPO 2500 for a family of four
(34, 36, 3, 1) and pay $350/month (they just raised the rates
from $300) and it pays maternity (with $2500 deductible). This
also pays for 70% of well visits and vaccinations, etc. I think
it's very reasonable. If you are healthy with no pre-existing
conditions I really think it's the way to go. We could have
purchased Kaiser, but like the providers we have with our PPO.
I have been self-employed and am also now a SAM / WAHM myself
on my own insurance plan. Since going freelance, I've been
amazed to discover what affordable options are out there for
the reasonably healthy self-employed--far better rates than
COBRA for sure! Although the rates have climbed for us as for
everyone. I am in the middle of switching to a new plan right
now and would encourage you to go to www.ehealthinsurance.com
where you can see ALL the rates and plans available to you as
an individual, and also for yourself and family members to
compare. The most affordable plans don't usually cover
maternity, but there are several options that do--look for the
baby icon and check the specs. I was VERY HAPPY to discover
BlueShield's PPO Spectrum plans in particular. Check out the
2400 plan for individuals or the 4800 plan for your whole
family--they are just high enough deductibles to qualify for
the pre-tax health savings account (HSA) you can get as an
individual through Wells Fargo ($3/month, but we're coming out
WAY ahead). The main thing to look at is the max out-of-pocket
amount you'd have to pay in a calendar year--that's higher than
the deductible and will be your bottom line for a baby delivery
year (or any major event year). In switching from my old
individual HMO with Pacificare, I'll be saving $400 / month in
premiums for myself and my 2 daughters, plus we'll be adding my
husband to the plan for the same exact rate. We'll still pay
the same $35 copayments for regular check-ups as with the
current plan, but unexpected appointments will cost us more,
the BlueShield contracted rate. Still, in a relatively
uneventful year, we will be coming out way, way ahead from my
previous HMO. And in a major event year (birth) we'll still be
just under what we were already paying per year. With our
monthly savings, we can start socking away a little per month
into the pre-tax HSA account to use for doctor's appointments
and prescriptions (this could also really help you save up for
the birth expenses). Unlike most work flex-spending accounts,
you don't have to use it or lose it within a year (you can
build it up like an IRA). One final note: if you know you have
a birth on the horizon, it may behoove you to get the
individual plan for yourself, with your own lower
deductible/max out-of-pocket for the year of the birth, and put
the rest of your family on the separate plan (unlikely they
will max out). Sorry this isn't better organized, but I hope it
helps! Good luck!
I'm considering leaving my job and becoming a stay-at-home mom.
But my husband is self-employed and we would have to pay for our
own health coverage. We have two young kids and have no major
health problems, though my son has some allergies and gets sick
easily. We've used Kaiser in the past and prefer not to go that
route. Does anyone have a PPO health plan they like that isn't
too expensive? Any suggestions/recommendations/tips would be
Soon to be SAHM
When seeking health insurance I recommend working with a
broker. They have much to offer in terms of knowing what is out
there, knowing what is a good match for you, and knowing how to
get your application in order so you will be accepted. They
will also act as your advocate if you have questions you are
trying to resolve. I think Bett Martinez is very good. She has
a small operation, and she specializes in quirky sitations such
as obtaining plans for small groups, non-profits and for people
who may have a complicated medical history.
She can be reached at 510-526-0312
We have individual PPO plans through Blue Shield of California,
and we have had no problems with them at all
Health insurance is an expensive proposition. I think about it
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
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 out 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?
I'm in the process of leaving my ''normal'' job and buying a small
business, meaning that I will be self employed. The one thing
that really scares me is how to deal with insurance, since the
insurance through my current job is the only insurance my family
has. Does anyone have advice about how to deal with insurance
when self employed? It seems to be unbelievably expensive.
I highly recommend Diane Sickman, a local Oakland woman I have know for
years. She is a former teacher and spends as much time with potential
clients educating them, as needed. She is smart, honest, and makes
insurance very easy to understand. She prides her self in being helpful,
and kind, whether she makes a sale or not. She works for Allstate
Financial and her office is in San Rafael. I know her history of helping
folks out with getting the issues and options clear, and then if they
want, helping them choose any kind of insurance, although health
insurance is her current specialty.
I know you will enjoy her and encourage you to call her. And she has a
live person answer the phone, not a voice mail run-around!
Diane Sickman, Personal Financial Representative, Allstate, 532 4th
Street, San Rafael, CA 94901 415-453-4300 Louise G
We are also self employed and have Blue Cross Blue Shield PPO with a
$2500 deductible (per person). This is for a family of four (ages 33,
35, 2 and baby). Our monthly cost is $303 and as you may already know,
part of it is tax deductible when you working for yourself.
We chose a high deductible because we rarely see a doctor besides a
yearly physical and they still pay around 80% of our well visits for our
baby, preventative care screenings, etc.
We also received a preferred rate for being in excellent health and no
prior health issues.
We went through a broker named Brian Fitzpatrick and his number is
My husband is self-employed and I took a year off from work after our
child was born. During this time we paid for Individual Plans from
Kaiser... One thing to keep in mind is that it was less expensive to
have separate plans for each of our family members (2 adults and one
child), than to have a Family Plan.
But it was still ridiculously expensive. Around $600/month, I think.
Health Insurance companies consider two a group. So if you have an
employee you may qualify for a group plan rather than an individual one.
Other ideas are- there are a few associations out there that still have
plans available- my association provides a group health plan for our
attorney members. One other avenue to check out is alumni associations-
sometimes they have special buying power. My organization uses a
Insurance Broker- Myers-Stevens. You might give them a call as well as
they can walk you through this process and tell you what's available to
you 1-800-862-4243. Good luck!
Congrats to you on going solo!
I just recently made the jump as well, and like you, feared securing (or
not) personal health insurance for my family. We were able to secure a
family health insurance plan at what I feel
is a great price: well under $500/mo for 2 parents and 2 kids).
It seems that the trade off that we had to consider was: how much did we
want to pay per month and then how much risk did we want to assume
throughout the year. Since we've all been healthy, we took a low
monthly payment with a moderate deductible and low out of pocket
maximum--or in other words we plan to be healthy or just a little bit
sick. If something catastrophic occurs, our out of pocket risk is
relatively low. We didn't get prescription coverage. You can also
apply for a health savings account with our plan and put away money for
health care at a pre-tax rate. Nice.
We ended up going through an insurance broker in SF. Although we worked
with someone who seemed relatively green, she did her homework and had
the guidance of the owner of the firm and we were collectively
successful getting a great plan. They are Shargel & Co.
www.shargel.com. (they have info on their web site for small business
plans as well)
I will say that the process of applying is fairly brutal. These
companies want a tremendous amount of detail on any health issues you've
had going back 20 years. I found that part infuriating, but we made it
through and got approved at a good rate (based on our family's overall
health rating and age). I've applied in the past and not been
successful. There are also more expensive programs available if for
some reason the insurance company won't accept you for an
I'd say: start working immediately on finding personal health insurance.
It takes 6-ish weeks start to finish. You might be able to get your
coverage and avoid having to pay for Cobra, which for us would have been
--happy to be insured
I was self-employed for years and during that time we had Blue Cross
(HMO--CaliforniaCare) insurance for my family of four.
It did get more and more expensive as time went on, but that reflects
what's happening for everyone, even if your employer pays part or all of
that cost. By the time I took a ''real'' job almost 3 years ago, I
think it was costing us about $400 a month. That's just medical. We
didn't have dental or vision insurance. I'm sure it's gotten higher.
During the time I was self-employed, my frustration was that I was never
able to find any other choices. Blue Cross and Kaiser seemed to be it.
I heard about other possibilities, through alumni associations, for
instance, but never found anything we were eligible for.
Maybe someone else on the BPN will know of some other options.
The good news is, the Blue Cross insurance was accepted by everyone, the
coverage seemed to be just what we were used to (and just what I now
have as an employee) and you can cancel at any time if you find
something else. Good luck with it!
My husband and I are both self-employed musicians, in
need of comprehensive health insurance (preferably PPO)
for our family. Any suggestions of where on earth to look?
Are there any groups we could be a part of for better rates?
Check out www.ehealthinsurance.com
Used to insure myself
Another source for insurance to cover self-employed
musicians is www.fracturedatlas.org, which starts at $75
We both had individual policies for many, many years (20+) through Blue Cross
of California, before leaving the state in 2000, so I could attend graduate
school. We had no trouble getting coverage in Oregon, and both have individual
policies through Regents Blue Cross of Oregon. Now that school is done, and
we are ready to come home, my partner and I find ourselves categorized
''uninsurable.'' He is a self-employed children's book illustrator. The catch is
that he is a Type I diabetic -- otherwise in excellent health --, but using an
insulin pump. I take antidepressants for mild bipolar disorder, and therefore
also have a pre-existing condition. (Who doesn't?) Is there
anyone out there who has some advice, has ''been there,'' and can allay some of
our fears. We've been steered towards a MRMIP plan, but need more
E & K
I have diabetes and am self-employed also, and it's very difficult in
California to get
health insurance! I was able to become a member of Media Alliance (in
they let anyone join, and have been covered by their group plan, which
many choices of insurers, BC,BS, Kaiser, HelathNet.. I think you now
have to actually
show that you do work in ''media'', but this may be possible for your
then you can be covered as his partner. Good luck -
Any suggestions for ways that a self-employed person can get a
group insurance plan? I've heard that some coops might offer
this option to non-worker members, but can't find one that
does. I have an individual plan now but am seeking options.
I checked the website and didn't find this information.
Try PacAdvantage. You should be able to find it on the
internet. It's what's formerly known as the HIPC - Health
Insurance plan of California. Its for small employers (2 is the
minimum I beleive), but allows you to take adantage of group
rates and benefit plan designs. Good luck
I have a small business and we get our health insurance
through something called California Choice. I believe the
website is www.calchoice.com. It groups all the small
businesses and individuals together into larger groups to
get better rates. Amongst our employees, some are on
HealthNet, some on MaxiCare, some PPO, some HMO. It's
worked really well for us. Our broker is a fellow named Joe
Danes with ISU Insurance Services based in San
Francisco. His assistant is Jeannie Grollman and the
number is 415-625-5177.
Some professional organizations sell group insurance. I know
IEEE does, and it's a pretty good deal for what you get.
Worth checking into, anyhow.
When I was looking, I found a group plan through UC Alumni. Anyone
could join the Alumni association, even if you never attended school
there. The plan wasn't bad, but we ended up going with one through a
professional organization. If you are a member of such an organization
you could check with them.
My health (HealthNet HMO) and dental (Delta Dental) is running out December 1 (COBRA) and I need new insurances. I am self employed and need it only for myself. HealthNet offers individual coverage, similar to the one I'm having now, which costs $225,- per month. There is also a plan for $70 less but with a higher copay and a yearly hospital deductable of $2000,-. I have been to the hospital 3 times during my life which was for three labors/deliveries, and since I'm done with having children, I am considering that option, too.
Which other health plans are similar to HealthNet/ have the same doctors on their list of providers? Are there any plans which I should stay away from?
The other/bigger question is about dental insurance since Delta doesn't have individual plans (as far as I could tell from their webpage). I love my dentists (Dr. Ota/Dr. Honda) and would like to continue with them. I am looking for a dental plan (HMO preferably), which covers most of the dentists here in the area (like Delta does). What would be a reasonable dental plan which offers this? Any recommendations are highly appreciated!
Thanks a lot!
I looked into this for our entire family about 3 years ago. The best deal I
could find for health insurance (HMO, same doctors as before in Alta Bates
Medical Group) was through Blue Shield. I couldn't find a dental plan like
Delta Dental, though. My dentist's office recommended that we self-insure
(i.e., just pay as private patients) and it has worked out so far. All of the
dental plans I looked at only had partial coverage. Some health insurance
plans also offer something like a dental PPO which is very inexpensive but the
dentist choices are limited; ours still didn't seem worth it for us.
Delta does offer a dental HMO through its affiliate PMI. It's called DeltaCare for families and individuals. You'll see a giant link on their home page at
www.deltadentalca.org which will take you to their online enrollment form.
Granted, this is not the Delta Dental you're probably used to. Using an HMO means you must select from one of the dentists on the HMO panel (you'll see a list online), you'll probably be paying some copayments since it is a self-funded program (your employer isn't subsidizing it) and you may not always be able to get an appointment exactly when you want to. But I think these limitations are common to all dental HMOs and not Delta's
If you truly want a plan that allows you to select most dentists, you're going to have to select something other than an HMO -- probably a PPO. It will be significantly more expensive, and more difficult to find individual/family coverage.
I was in the same position you are last spring. After doing some research, I decided on a Blue Shield PPO -- I pay under $200/month, high copays and some hospital deductible. However, given that I rarely go to the doctor or the hospital, I think it's a better bet than a higher monthly premium. After all, it's just trying to make an educated guess as to what will be more economical, given your situation. As for dental, all the HMO's I looked at only had very limited panels of dentists. Delta seemed like the only good plan around, and it was a higher monthly cost than I wanted to pay. My dentist, whom I adore, suggested that I not have dental insurance but assume that what I would pay out of pocket would not excede what I'd pay for insurance. I also had any optional work done the last month before the insurance expired.
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