Quality Individual Health Insurance in NY?
April 3, 2011 7:25 PM   Subscribe

I need to buy (gack!) my own health insurance. I'm in New York state. I'm looking for very good coverage. Would rather pay more for high-quality, flexible, non-nitpicky coverage (if such a thing exists), and then economize by opting for high deductibles. I once lived in CT for a short while, and loved Anthem Blue Cross. But I've heard horror stories about Empire Blue Cross in NY. What other options are out there?
posted by Quisp Lover to Health & Fitness (13 answers total) 4 users marked this as a favorite
Best answer: Are you self-employed, low-income or eligible to buy into group insurance? The options for people who don't fall into any of those categories are extremely expensive policies -- in the neighborhood of $1,000 a month per person -- or strictly catastrophic coverage. You can see several options for individual policies at http://ehealthinsurance.com, but note that many of the more moderately policies specify "self-employed only." There are specific definitions of who qualifies as self-employed you will want to check, if you may be eligible for those.

As far as which companies to seek out, I can tell you that Aetna and Oxford have the largest networks in NYC. I've been insured by both without incident.
posted by reren at 7:44 PM on April 3, 2011

As a small data point, we had Empire BCBS for a few years and never had a problem with it, even though we lived outside NY. This was for a family with young kids and, I would guess, an average number/type of claims.
posted by lakeroon at 7:56 PM on April 3, 2011

We bought ours through a broker. MeMail if you want to know more.
posted by Obscure Reference at 5:06 AM on April 4, 2011

Response by poster: reren, individual self-employed (though not exactly raking it in, so if I need to show a certain income minimum, I may be screwed).

Thanks, others!

Hope a few more replies come in....
posted by Quisp Lover at 6:24 AM on April 4, 2011

Find an independent agent/broker and talk to them.
posted by thatguyjeff at 6:25 AM on April 4, 2011

Best answer: Second what thatguyjeff said. Also, Anthem acquired Empire several years ago (Dental and Vision, at least. Though I can't imagine acquiring their specialty business and not the medical) so the customer service, claims processing, etc will be the same folks.
posted by bluejayway at 7:24 AM on April 4, 2011

Best answer: Honestly, ehealthinsurance is likely to show you all the options that exist. Brokers might be able to customize things for you a little bit, but if you want to know your options, ehealthinsurance is the way to go. They helped my family (in Washington) find an unexpectedly reasonable policy.
posted by KathrynT at 8:38 AM on April 4, 2011

Response by poster: Woah!!!

I just went to ehealthinsurance. I can pay an exorbitant $1,289/month for Empire Direct Pay HMO with no out-of-network coverage, and I must get specialist referrals.

Or $182/month for Empire TraditionPLUS Hospital Program, covering only in-hospital expenses (and the catch on this - which is responsible for lots of the fury among Empire customers - is they craftily word it "Hospital-billed services covered in full", which excludes private medical bills incurred while in hospitals. And lots of stuff that happens to you in hospitals gets billed via private channels (e.g. doctors who aren't on staff).

The only other choice is GHI Alliance Value, which is expensive, spotty, and poorly-rated. I don't see Oxford or Aetna options listed (I'm in Westchester County, fwiw).

With CT Anthem, I paid $333/month for great coverage, total out-of-network coverage, no referrals necessary. So I have to pay nearly quadruple for worse coverage?!?
posted by Quisp Lover at 12:04 PM on April 4, 2011

Best answer: America! What a country!! (IOW: yes, probably. That doesn't seem out of line to me. I looked up Aetna rates to be sure, and they're the same or more expensive, except for the Healthy New York option. Oxford wouldn't give me a quote without more information than I was able to fake.)
posted by KathrynT at 1:53 PM on April 4, 2011

Best answer: I recently went through something similar in Michigan, not New York, but didn't find that ehealthinsurance gave me all the options. Nor did agents. A lot of poking around on the internet was the most useful. This and this page were just slightly helpful; this one a little more so.

You might see if there's a New York state department that handles insurance complaints and issues. There's one in Michigan and they were able to tell me how many complaints each company I was interested in had.

I don't know why there's so little useful info about health insurance companies online.
posted by still_wears_a_hat at 2:41 PM on April 4, 2011

Best answer: You might want to check out Freelancer's Union. Seems like they have some reasonable options, if you qualify for their program.
posted by bobafet at 4:08 PM on April 4, 2011

Best answer: As a side note, the reason you were able to get relatively inexpensive coverage in CT is that your insurance company saw you as a good risk. In New York, insurance is community rated, meaning they have to offer the same rate to everyone. Consequently, insurance is much more expensive and options are fewer. However, you won't be discriminated against or denied based on a prior medical condition. Perhaps that can be small consolation to you.

Also, it looks like ehealthinsurance is really not comprehensive. It appears that Aetna does offer unsubsidized individual policies in Westchester County. They just don't want you to know about it. And you're not going to like the price. However, this Web site shows several somewhat more attractive options for a self-employed person in Westchester County. A broker may be able to inform you of still more options.

If your income is low, look into Healthy NY. (For an individual the cutoff is about $2,000 a month.) Here is the official eligibility screener. If your income is really very low, you can try Medicaid.

It seems extremely unlikely to be relevant to you, but I'll go out on a limb and point out the NY Bridge Program.

And, yeah, look into Freelancer's and its ilk.
posted by reren at 7:43 PM on April 4, 2011

Response by poster: Thanks, all. Maybe I shoulda stayed in CT!!
posted by Quisp Lover at 6:40 PM on April 7, 2011

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