Cheap Health Insurance for the Self Employed?

November 11, 2004 7:10 PM

Now that I'm no longer on the corporate payroll, I've discovered for myself the horrors of the American health-care system: to continue my medical and dental coverage through COBRA costs me over $850 a month (for me and my wife). This is far more horrifying than mortgage, taxes, &c., and I don't see how I can continue it (I'm doing it now to avoid the dreaded lapse in coverage). Anybody have suggestions for cheaper health insurance available to the self-employed? (I'll almost certainly be living in western Massachusetts, for what that's worth.)
posted by languagehat to work & money (17 comments total)

Once when I was in that situation, I signed up with Kaiser Permanente. It was affordable, and for my needs, it was just fine. I had to go to their clinics, but I didn't really care, 'cause I only go maybe once a year and the clinics were actually quite nice. I would check to see what they offer these days, if they do business in your area.

Another time, after that, I got a policy with Blue Cross/Blue Sheild, who were running a promotion to attract self employed folks at the time. It allowed me to go to any doctor I wanted, but I didn't find out until it was too late that there was no drug coverage. My fault, I know, for not reading the fine print, but one bottle of $90 nasal spray and I learned my lesson.
posted by spilon at 7:22 PM on November 11, 2004

COBRA costs a lot and doesn't last for very long. Are you both young and healthy? If so a high deductible plan may be a good stop-gap until you are back on a payroll with insurance benefits. I used the Golden Rule once with a $5,000 annual deductible. Basically you pay all expenses unless something really catastrophic befalls you. For the long term I think many folks go with Blue Cross/Blue Shield - but this is probably about the same as your COBRA payments. (Is a national health plan looking better yet?)
posted by caddis at 7:28 PM on November 11, 2004

Avoid the lapse in coverage at all costs--you don't want to end up with a PRE-EXISTING CONDITION!!! I did the cheap Blue Cross/Blue Shield coverage for a six-month period and it at least let me sleep at night, knowing that hospitals wouldn't turn me away. For about $70/month, I got some kind of coverage for generic prescriptions and could go to one of their in-plan doctors for something like $40. (This was in California, a couple of years ago. If I remember correctly, you can get a quick quote from their website.)
posted by _sirmissalot_ at 7:38 PM on November 11, 2004

One option would be to go through a health insurance broker - find one in the Yellow pages, or through Google searches. Talk to a few and find one you feel comfortable with. Brokers get a commission from the company (at least in California) so this will not add to your cost. Find one who sells plans of multiple companies. They will be able to find you something cheap and suitable. They will also help you go through the application process.

Or you could search on one of the online sites such as ehealthinsurance.com (which is also a broker).
posted by rsinha at 7:50 PM on November 11, 2004

My sympathies, languagehat. My permanent coverage is with NHIC... they've been pretty good for the last two years, though I've never had to make a serious claim with them (and that is one of the reason why private health insurance is broken: you never know how good a company is until you have to make a serious claim, and by that time, if you chose wrong, sorry, out of luck).

See also some previous discussion here, here, and here. And here, in which I also pointed to those three previous heres, if nothing else, just for the deja vu.
posted by weston at 7:50 PM on November 11, 2004

My alma mater's alumni association had a group plan - you might check yours. I've also heard that some of those mega-churches are offering plans for members. I don't know if you have any in west Mass (you'd know - its the church that seats 20000) but Jesus might cover you if you do.
posted by jmgorman at 8:31 PM on November 11, 2004

I've mentioned this a couple times in past threads, but ehealthinsurance.com really did help me find coverage during a between jobs period. I paid $45 a month for the first six months, $90 a month after that. It didn't cover prescriptions, but it was better than major medical--I only had a small copay when I went to the doctor.
posted by croutonsupafreak at 9:10 PM on November 11, 2004

Benefits listings from the National Association of the Self-Employed. My mom gets her insurance through this organization, and she's quite happy with it.
posted by WolfDaddy at 10:03 PM on November 11, 2004

I was distinctly unimpressed with the NASE. I had them for a little over a year, from 1998 to 1999. During that year, they raised my rates from $70/mo to $140/mo, citing the "increasing costs of health care" in the letters that they sent me for each of the three hikes. I'm sorry, health care costs do not double for the general population you cover inside of a single year, much less for healthy 26 year old men who made no claims in that time period. And you would have had to be a moron to have lost money on investments in the roaring 90's.

This year, I learned that they got hit with a class action suit for something related to that kind of activity, around that time. I was eligible to participate, but didn't, since the benefit was a few months of free limited coverage. Hah.
posted by weston at 11:25 PM on November 11, 2004

Several thoughts:

Local chambers of commerce often have group plans for self-employed residents of a municipality. The restrictions on membership are often surprisingly lax.

Professional networking organizations of various stripe occasionally broker either group health plans or discounted memberships to organizations (such as chambers of commerce) that do.

I don't have a PCP (or don't regard myself as having one -- 'nother story for another time...). When I had a health problem a few months back, I stumbled across a health care hotline in one of the "special" directory sections of my phone book (blue pages, green pages, etc -- common in many phone books these days, usually at the front). While I didn't need it for myself, the person I spoke with there was able to provide pointers to lots of relatively low-cost plans. Nowhere near as comprehensive as what you'd have while employed, but as noted above, it avoids the dreaded "lapse in coverage" scenario.
posted by lodurr at 5:31 AM on November 12, 2004

Based on my experience, I would check the small print to see if you *are* getting the same coverage - COBRAs can also offer more limited coverage, as I found out a couple of months ago. I wound up with a high premium, and only accident/emergency coverage. It was also hard as hell to deal with the insurance company about this; they seemed to have no idea of what the policy actually was, and didn't send me a copy for a long time (although they were very willing to take my money).
posted by carter at 6:24 AM on November 12, 2004

If you're generally healthy, high deductibles will lower your monthly costs significantly (your plan basically becomes catastrophic insurance.) Slap the quotes and anticipated health costs (doctor visits, meds) into a spreadsheet to determine the best deductible.

Consider dropping dental insurance. My family has been without it for five years and even with biannual visits and a few fillings, it's been cheaper.

I used two brokers to get quotes. Work 'em hard, as it's probably the last time you'll ever talk to them.
posted by F Mackenzie at 6:33 AM on November 12, 2004

When I was self employed in western Massachusetts I asked at a local insurance broker and was given several options. I called myself a consultant and purchased an HMO plan for my company, in which I was the sole employee. My plan cost about $170 a month in the late nineties. I'll be glad to give you particulars of who I went to if you'd like them.
posted by Songdog at 7:33 AM on November 12, 2004

Being self-employed, I've covered my own health insurance...well, for as long as I've had health insurance.

I'm currently with Unicare, on what I refer to as a "don't get sick" plan (ie, very high deductible). My monthly (age 38, non-smoker) is under $100. I changed insurers a couple years ago because my previous insurance was getting too expensive. Much to my amazement, despite some pretty serious pre-existing conditions that could theoretically flare up into problems, the new policy has no exclusions for them.

In theory, I'm eligible for insurance through my wife's job bennies, but I'm unwilling to make my coverage contingent on her continued employment in a fickle industry.

I think the American Translator's Association (which you could join) has some kind of group plan for members (I am not one).
posted by adamrice at 8:56 AM on November 12, 2004

MediaBistro's AvantGuild has some kind of health care plan, as does the National Writers' Union. I have no idea what your wife's calling in life is, 'hat, but my guess is that whatever professional associations she may belong to have something similar.
posted by Sidhedevil at 5:27 PM on November 12, 2004

Thanks, everybody! (And thank you, Matt, for creating this wonderful resource!) I'll definitely check this stuff out.

Are you both young and healthy?

No, we're aging and creaky. But no serious health problems so far.
*knocks wood*

Apparently you can't get high-deductible plans in Mass.
posted by languagehat at 6:49 PM on November 12, 2004

i'm late, but to add-on:

I've had kaiser most of my life (they're apparently the state health care plan if your folks work in education). They've always been fucking great. Perhaps it's because I've never had a single doctor that I think this, and i've been told by many folks that "kaiser's great, unless you're terminal", but they've always treated me very well.

If you can get kaiser-permenente (i pay around $100 a month for a self-care plan, being a reasonably healthy 25-yo man) I'd go for it. *and* i say this having experienced minor surgery with them -- they took out my gall bladder --- after removing a gallstone from my bile duct earlier. I have nothing but good things to say -- i had blue cross with my work prior to having kaiser, and had the gallstone condition, and it was fucking impossible to find a doctor to listen to me. None of them cared and the ones I saw did not work in hospitals, so they didn't have the technology to even figure out whether there was a problem or not. I was told by one doctor that "he didn't 'believe' in painkillers" and that i "just needed to eat 'sick' food, like chicken soup" and that would heal it. Needless to say, I'm down with the HMO, as long as they get it done, and in my experience, kaiser does.
posted by fishfucker at 2:30 AM on November 19, 2004