Where do I start with purchasing individual health insurance?
June 12, 2012 6:32 AM   Subscribe

Where do I start with purchasing individual health insurance? I lose my current coverage on July 31, and I've been avoiding dealing with this for as long as possible. Right now, I feel a bit overwhelmed, and don't know what information to trust or where to start.

So - how do I do this? What should I expect? Do I apply to a bunch of companies and see what premiums they quote me? Any I should avoid? Is there some reputable central clearinghouse for policies? What do I need to look out for? What information do I need to gather before applying?

I'd even be willing to pay somebody familiar with Texas policies and regulations to help with this, but that just shifts the problem from dealing with insurance companies to finding somebody I trust to be informed and honest ...

I'm sorry if the following is TMI ... I'm posting anonymously for obvious reasons and wanted to cover everything.

Situational Details:

* I'm taking a leave of absence from grad school. I'll be bouncing around for the next year or two, until I either go back to school or settle down with a full-time job with benefits.
* I have a job lined up in Texas from August through March, but I have idea where I'll end up after that. I can use my dad's address as a permanent residence in Texas, if need be, but the plan has to cover doctors wherever I end up.
* As soon as I start my short-term job in Texas I'll have to undergo a pretty intensive physical ... so I feel like I need to get insurance now that I'd be happy to keep for years, just in case something turns up. If the premiums aren't ruinous, I may even keep it once I'm back in a more stable situation, because having health insurance tied to my school or job makes me feel trapped.
* I'm not eligible for COBRA, and the "conversion plan" I am eligible for is rather expensive. If I have to, I'll find a way to pay it, but ... it'd hurt a lot. I make too much to qualify for any income-based assistance, but not enough for $600/month to be easy.

Details about my health:

* I've had health insurance my whole life.
* 26, F. Normal blood pressure & cholesterol.
* I'm currently obese. It's been a stressful term, but I could probably lose 10 pounds by the end of July to get my BMI back in the overweight range if it'll make a difference. Worth stressing about?
* I have a heart murmur. About 6-7 years ago I got it checked out, and it's entirely benign.
* I saw a shrink for ~ 6 sessions last year because I was really struggling to get my work done. No meds.
* I was treated for acne a bit over a year ago, and am happy with the results. However, I still use a prescription face wash. It's not available over the counter, and would cost me ~$800/year out-of-pocket.
* I've had various appointments for sports-type injuries, but nothing major. (Well, the doctor freaked out about a potential head injury and ordered MRI and CAT scans, when I went in for a sore neck ... that's by far the worst)
posted by anonymous to Health & Fitness (11 answers total) 10 users marked this as a favorite
ehealthinsurance.com is one reputable company. Good place to start.
posted by Mr.Know-it-some at 6:37 AM on June 12, 2012 [1 favorite]

A high deductible plan is often the best bet for young single people in good health, but your acne meds likely will be out of pocket. Weight plus recent mental health treatment history could be a challenge though for premium - continuation plan could end up a better deal for you. Good luck!
posted by MattD at 6:42 AM on June 12, 2012

One thing that will make the cost go up or down significantly is maternity coverage.

As for "who" - what about your Texas Blue Cross Blue Shield? I've had BCBS for several states and it was fine - they have even opened up service centers for people who want to walk in and buy individual coverage.
posted by tilde at 6:44 AM on June 12, 2012

This is what insurance agents can be good for! Mine sends me a mega spreadsheet of options that I can choose from.
posted by vespabelle at 7:50 AM on June 12, 2012

I asked a similar question a few months ago, and valkyryn's answer was enormously helpful. Find a broker- I found one with an internet search. They'll run quotes for you and help you through your questions during the process and filling out applications. Ours was invaluable, especially for the kinds of questions you're asking.
posted by questionsandanchors at 8:15 AM on June 12, 2012

Young adults and the ACA.
posted by ClaudiaCenter at 9:20 AM on June 12, 2012

Seconding ehealthinsurance as a good place to start. Make sure you pick a plan that's portable and the "in network" isn't dictated by state.

Just to be forewarned, individual insurance is kind of brutal and will nitpick any tiny medical detail to deny coverage or up your premium. (A family member of mine got denied merely for having migraine headaches!) Your heart murmer, even benign, might get "points" added against you for both your premium or general eligibility. Obesity and mental wellness aren't show stoppers, but they will come up in the interview/physical part.

Good luck!
posted by ninjakins at 10:12 AM on June 12, 2012

I am in the process of applying for individual health insurance in Texas also. I live in Austin. I called a health insurance broker because I was feeling just as overwhelmed as you sound by the process. He recommended applying to either United or Blue Cross/Blue Shield because they each have about six plans to choose from, and they have the most doctors. He explained all the terms to me, such as copays, deductibles and how they work, and was willing to even walk me through the application process in his office if it proved confusing. I managed to fill out my Blue Cross application online and it was quite easy. A brief interview is the next step after filling out the form. I highly recommend using a broker, and if you happen to be in Austin, I can give you my guy's contact info via MeFiMail. If you're in a different city, I suggest Googling the name of your city and "health insurance brokers." It's well worth it to have a human who understands this complex, grueling process and can explain what you're getting covered for. They don't charge you anything. They make their money from the insurance companies. Let me know if you need more info.
posted by xenophile at 12:15 PM on June 12, 2012

nthing the 'contact the insurance broker' suggestion. i found the process to be pretty quick and painless and surprisingly affordable for a family of four.
posted by lester's sock puppet at 12:36 PM on June 12, 2012

I'd check out the high deductible health plans available now. We did this for several years and referred to it as our "cancer policy." Never needed it...but peace of mind... For two of us, healthy in our mid-30s to 40: $325/mo for a $10k/$4k deductible (out of/in network). That was Blue Cross five years ago.

As for that face wash, any chance you have friends in another country who could buy it over the counter and send it to you?
posted by AnOrigamiLife at 11:26 PM on June 12, 2012

Mod note: From the OP:
As a followup, in case it would help future people reading the thread: I wound up contacting an insurance broker, and all of my worries were misplaced. I was painfully complete in the application (and tracking down all the required info was indeed a pain), but wound up having no trouble getting a comparable plan to my school insurance for $240/month.
posted by jessamyn (staff) at 1:32 PM on August 1, 2012

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