Best insurance in the Bay Area?

January 23, 2008 3:10 AM

I'm a mid-20s male in the East Bay. I don't have health insurance, but am thinking about getting some. None is available through work. What are my best options?

I make about ~32k/year before taxes, and i am provided an extra ~150/month for health insurance. I have been pocketing the difference thus far, but going without insurance seems foolish; on the other hand, so does spending money unnecessarily. What options are available to me, what are the best for the lowest price, what would you recommend or stay away from? Optometry/Dental information would be helpful too.

posted by anonymous to health & fitness (9 comments total)

Try the BCBS Plan Finder

Or E-insure

One thing is that if you have any preexisting conditions, individual plans have more leeway in excluding coverage for those conditions, unless you qualify for a HIPAA individual plan...but it doesn't sound like you would, because one of the criterion is to have had coverage for a least 18 months without a significant break in coverage as of your enrollment date.
posted by Pax at 6:39 AM on January 23, 2008

I worked with Leone Calvert, an insurance agent, to find my health insurance in the East Bay when I was a mid-twenties female in a similar situation. She was great to work with, found me a great plan, and didn't charge anything. She should be in the phone book under "Insurance" or "Insurance Agents."
posted by Eringatang at 7:12 AM on January 23, 2008

In terms of what plan is "best" for a given price, California is one of the few states that puts out really good information on how HMOs compare on a variety of quality measures. (Unfortunately, similar info isn't published for PPOs.) You can find the 2007 scores for California plans here. If you get to the point where you're trying to decide between a few plans, looking at those quality measures would be a good way to decide which plan will offer "better" care. Googling around a bit should also probably turn up the average number of complaints for each plan (usually such info is reported on the state department of insurance website), which is a good metric for determining how much of a headache your insurance company will give you if you get sick and have to deal with paperwork and pre-approvals.

In a more general sense, you probably want to figure out what type of insurance you want before going into an insurance agent, as it's a better use of your time to know the broad parameters of what you're looking for (HMO? PPO? High or low deductible? Including vision and dental?). There's two different "ways" that insurance can work when you're covered in the individual market: you can buy a lower-cost plan that insures you against low-probability, high-cost events (serious illness or injury, ER visits) but doesn't do much in terms of going to the doctor when you need antibiotics, or a higher-cost plan that both insures you against those high costs as well as smooths out your spending on preventative care and routine doctor visits into predictable monthly chunks. It sounds like you might be happy with the first type of insurance. However, one thing to keep in mind is that even if your insurance only covers the high-cost stuff and doesn't cover the routine doctors visits, finding an insurance company that has negotiated discounts with a lot of providers in your area means you'll have to pay less for those routine things even if you pay out of pocket.

Dental and vision coverage are almost always exclusively the latter type of insurance that exists solely to smooth spending rather than to insure against the risk of high-cost but low-probability catastrophic outcomes--you'll almost certainly pay nearly as much for coverage as you would out of pocket for optometrist exams and cleanings (and if you think about it, that makes sense, as the only people who really buy vision insurance already wear glasses or contacts and so will certainly use it--there's not much risk pooling going on). The dental/vision insurance company might have negotiated discounts with certain providers, which could save you money; on the other hand, you're also having to pay to cover administrative costs for those plans, so it's probably a wash.
posted by iminurmefi at 7:49 AM on January 23, 2008

First check out Tonik. It's made for you, it's cheap, and includes dental and vision. But it's REALLY hard to get because it's not underwritten (they don't do an exhaustive search of your medical history, but if you don't tell them something and it shows up on your medical records when they check, you are immediately barred from the plan. You are also barred if they see something disqualifying/they don't like...drug treatment, therapy sessions, preexisting conditions, certain types of hospital visits, etc.). Don't fear if you don't get in. Blue Cross has other plans that are a little bit more money and comparable (but sadly without medical and dental).

You can apply for Tonik easily online. If you are rejected (I was), try calling Blue Cross and talking with a representative. I was able to get onto another plan for $100/mo (Tonik is cheaper, but oh well). They were extremely helpful and I am very happy with how little bullshit I had to endure.

To be honest with you, medical and dental insurance aren't really worth it right now. Maybe that will change one day, but if it's not included in the plan at super cheapness, don't bother.
posted by iamkimiam at 8:27 AM on January 23, 2008

Oh, and yes, the Tonik site tries waaay to hard to be cool (really, really painful marketing), but if you can get past it, the plan does indeed rock.
posted by iamkimiam at 8:30 AM on January 23, 2008

I had good luck with the National Association for the Self Employed
posted by chickaboo at 10:54 AM on January 23, 2008

I had a personal plan from Blue Cross when I first moved here and had no insurance through work. I'm in my 20s, single, and healthy, so I got a basic plan with no prescription drug coverage, just in case I needed to go to the ER or something. I think it was less than $200 a month, and it was easy enough to get, but I don't think I ever actually went to a doctor while I was on it. I ended up only needing it for about three months.
posted by autojack at 11:36 AM on January 23, 2008

You might consider talking to an agent. Their job is to understand the vagaries of CA insurance and work out the best possible deal for you. They don't get paid by you directly, so you have nothing to lose (except an hour or two of your time) by shopping around and talking to different agents.

I have a recommendation* for you, in Walnut Creek, if you're interested. You can email or MeMail me if you want further info.

*Caveat; my girlfriend used to work there as an agent, but no longer does.
posted by lekvar at 12:14 PM on January 23, 2008

I had good luck with the National Association for the Self Employed

Oh no no no.

I got taken in by those crooks 10 years ago. I fortunately never had to actually rely on the insurance, but I knew something was very wrong when my premiums doubled inside of a year.
posted by weston at 11:55 PM on June 2, 2008