A better insurance plan
June 16, 2005 7:58 AM   Subscribe

I'm an IT contractor. My pimp doesn't offer health insurance, so its up to me to get a private policy. My wife has MS, so she's uninsurable. I have an individual BCBS plan for myself + 2 sons. My wife belongs to a state-supported Health Insurance Pool, for people who have been denied coverage. We pay a LOT of money ($360/month) just for her premiums. Its analogous to people with bad credit trying to finance a car - they have to pay extra for the privilege. Do I have alternatives? Are benefits-pooling companies worth it?
posted by neilkod to Health & Fitness (11 answers total)
The high-risk pool is a godsend. I'm on it too. You're lucky to only pay 360/month, as here in Connecticut the cost for women starts at $500 and shoots up from there with age.

Health insurance is based on the expectation that most people will either never file claims in a given year or seek generally low-cost services such as annual checkups. Everyone in the high risk pool, by contrast, will file claims that typically far exceed their premiums. It's a guaranteed money-loser, which is why subsidization is necessary.

I'm not sure what your alternatives are, but I'd implore you to realize that south of Canada, it doesn't get much better than this.
posted by Saucy Intruder at 8:16 AM on June 16, 2005

I hate to break this to you, but $360 a month with a pre-existing condition is AMAZING. I'm in NC, completely healthy, and I (and my company) pay about $300 a month for me, with another $200 per month for my also completely healthy 13 year old. You aren't going to find anything cheaper.
posted by mygothlaundry at 8:36 AM on June 16, 2005

I think that it is time for you to leave contracting and get a permanent job with benefits so that you can support your ailing wife. I realize that might impact your freedom and perhaps even your income, but having the ability to pay for your wife's care would seem to trump those issues.
posted by caddis at 8:48 AM on June 16, 2005

I've been in a high-risk pool before, and I can also say that $360/month is indeed a bargain (relatively speaking!). If I were to go back on the market off my employer group plan, I'd be paying close to twice that to insure myself (and I'm single, under 40, with no kids).

I think caddis is right that you need to consider a full-time job with benefits that include a group health plan with an open enrollment period. It's my understanding under the HIPAA laws (1996) that as long as someone's been insured in the previous 63 days when they want to roll onto a group plan, the insurer must take them despite pre-existing conditions. (There are a lot more complications/loopholes/etc. to HIPAA/COBRA rules than that, of course, but that's the gist of it.)
posted by scody at 9:33 AM on June 16, 2005

I think you should consider moving to a country that has guaranteed health coverage for all its citizens. This is one of the major reasons I'm in the process of moving to Canada.
posted by Civil_Disobedient at 9:41 AM on June 16, 2005

If you think $360/month is high, you probably aren't making enough money as an IT contractor, and should consider getting a full time job somewhere.

Even if it is only temporary, it gives you options. Once she has regular insurance, HIPAA gives you some options. You should look into it.

I recently stopped paying $1400/month when I got a full time job. Me, wife, two kids. No pre-existing conditions.
posted by bh at 11:48 AM on June 16, 2005

In fact, 360 is so low that if you got a full time job, then quit that job and went on COBRA, you'd probably be paying close to 360 anyway.
posted by Saucy Intruder at 12:20 PM on June 16, 2005

I hate to dogpile, but I gotta chime in and agree that $360/month is not at all high. That is an AMAZINGLY low figure for someone with MS. I'd get down on my knees and thank god for such a low number. So no, it is not analagous to people with bad credit trying to finance a car.

To reiterate: that's an amazingly low figure.
posted by Justinian at 1:02 PM on June 16, 2005

I think you should consider moving to a country that has guaranteed health coverage for all its citizens. This is one of the major reasons I'm in the process of moving to Canada.

I'm not sure if you're just going because you want the health care despite being healthy, or if you have a pre-existing condition that you're specifically concerned with, but it's worth noting that medical status is a factor in whether Canada will accept people. Pre-existing conditions with potentially very high long term costs are a reason why they'd turn someone down for immigration.
posted by jacquilynne at 3:19 PM on June 16, 2005

No pre-existing conditions, jacquilynne. Just thinking ahead. No first-world country has any excuse for either homelessness or lack of universal health care. The financial burden of catastrophic injury in this country is scary enough when you're not living paycheck-to-paycheck. Thank you for the additional information, though.
posted by Civil_Disobedient at 3:27 PM on June 16, 2005

$360 a month for your wife is very low. Very low. When my husband got laid off and I was pregnant, our COBRA coverage was almost $1000 a month.
posted by dejah420 at 6:17 PM on June 16, 2005

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