What kind of health insurance should I get?
May 16, 2013 9:02 AM Subscribe
I'm a single woman in her early 40's, unemployed (mostly), looking to purchase health insurance, and requesting advice from the hivemind on how much I should have, of what type.
I'm 41, a single woman, no kids now or ever, a bit overweight but otherwise in pretty good health except for low-grade depression (dysthymia). I live with and look after my elderly mother and I also get some work in our little island community by walking dogs and pet-sitting, but there's very little other employment available. If I keep trying, I could probably get a part-time job at a store, but full-time, and any kind of company health insurance that comes with it, is pretty much not going to happen. While I don't have a lot of money, I also have no debts, but I realize that that could change, big-time, with one bad accident or illness. So I'm thinking I really should buy my own health insurance. The question is, what kind and how much should I get? I have USAA for my auto insurance and was thinking of using them for health insurance as well, but I'd still like advice on just what would be the best sort of plan for a person like me. Thanks for any help!
I'm 41, a single woman, no kids now or ever, a bit overweight but otherwise in pretty good health except for low-grade depression (dysthymia). I live with and look after my elderly mother and I also get some work in our little island community by walking dogs and pet-sitting, but there's very little other employment available. If I keep trying, I could probably get a part-time job at a store, but full-time, and any kind of company health insurance that comes with it, is pretty much not going to happen. While I don't have a lot of money, I also have no debts, but I realize that that could change, big-time, with one bad accident or illness. So I'm thinking I really should buy my own health insurance. The question is, what kind and how much should I get? I have USAA for my auto insurance and was thinking of using them for health insurance as well, but I'd still like advice on just what would be the best sort of plan for a person like me. Thanks for any help!
What state? Some have low-income insurance options, like Healthy New York.
posted by Riverine at 9:23 AM on May 16, 2013 [1 favorite]
posted by Riverine at 9:23 AM on May 16, 2013 [1 favorite]
Response by poster: I've got a couple thousand in the bank and then about 30 or 40 thousand in various investment funds and things I could draw out if I had to, but that's kind of my "life savings" so... :) I'm in Washington state.
Thanks for the questions! I'm trying (at this late age) to be a Responsible Adult after having all this sort of thing done for me by parents, spouse, etc, so I'm coming from bare ignorance here.
My investments guy (whom I just called to ask about the funds I have) said I should definitely get a high-deductible plan because I do have some funds. Sound right?
posted by The otter lady at 9:27 AM on May 16, 2013
Thanks for the questions! I'm trying (at this late age) to be a Responsible Adult after having all this sort of thing done for me by parents, spouse, etc, so I'm coming from bare ignorance here.
My investments guy (whom I just called to ask about the funds I have) said I should definitely get a high-deductible plan because I do have some funds. Sound right?
posted by The otter lady at 9:27 AM on May 16, 2013
I know several USAA customers and they are all uniformly happy with them as an insurer.
posted by rmd1023 at 9:34 AM on May 16, 2013
posted by rmd1023 at 9:34 AM on May 16, 2013
Yes, you can quite a bit of money by choosing a high deductible. You'll need to consider how much you could pay out-of-pocket in an emergency while still being able to pay for rent and other necessities and not endangering your long-term finances (e.g. losing most of your retirement savings), and choose accordingly.
posted by mbrubeck at 10:11 AM on May 16, 2013
posted by mbrubeck at 10:11 AM on May 16, 2013
Washington State is a pretty decent place to buy individual insurance, but it still costs money. First things first, shop around and see what's available at the various price points. Ehealthinsurance.com is a pretty easy way to get a sense of the price of plans in Washington. And definitely check with USAA.
Does your investments guy know that you are only marginally employed? Are these investments in an IRA? (Because it would cost you in taxes to pull the money out to pay bills.)
At 41, I would hesitate over a high-deductible plan, because as you get older more health things crop up - you wouldn't want to be stuck paying that deductible year after year. It sounds like your income is pretty low - would you qualify for Washington Basic Health? (Maybe you could bypass the waitlist as a "personal care worker"?)
Another thing to consider, as a self-employed person you can take a tax deduction for health insurance premiums. You may want to factor that in to your affordability calculations. Have you thought of expanding your business a bit? A lot of the retired folk on the islands need a hand with this and that - it's not the path to riches but you could further supplement your income, and then with proper deductions and so forth still keep your taxable income extremely low.
posted by stowaway at 10:42 AM on May 16, 2013
Does your investments guy know that you are only marginally employed? Are these investments in an IRA? (Because it would cost you in taxes to pull the money out to pay bills.)
At 41, I would hesitate over a high-deductible plan, because as you get older more health things crop up - you wouldn't want to be stuck paying that deductible year after year. It sounds like your income is pretty low - would you qualify for Washington Basic Health? (Maybe you could bypass the waitlist as a "personal care worker"?)
Another thing to consider, as a self-employed person you can take a tax deduction for health insurance premiums. You may want to factor that in to your affordability calculations. Have you thought of expanding your business a bit? A lot of the retired folk on the islands need a hand with this and that - it's not the path to riches but you could further supplement your income, and then with proper deductions and so forth still keep your taxable income extremely low.
posted by stowaway at 10:42 AM on May 16, 2013
We used ehealthinsurance.com a while back. They're a friendly company, I was happy working with them (not so crazy about Humana that we went with, so far).
I would certainly look into assistance programs. Also, note that you may have better assistance options in 2014 with the Affordable Care Act provisions.
High deductible sounds like a good idea in your case, if you have no important existing issues. (If you've not been officially diagnosed dysthimic, it's not part of your medical history, you don't need to mention it.)
Finally, I will be a little heretical and say that it is not necessarily irresponsible to go without health insurance. Health insurance can be unreasonably expensive.
(It is also true that one bad visit to the emergency room could be $200K--but you might be able to pay it off at $50.00 a month for the rest of your life, or just refuse to pay the bills and take the hit to your credit rating. Developing a chronic condition is (to me) a scarier scenario, but again you have the ACA rolling out in 2014--you can go buy the insurance then if you need it.)
You may be able to find health insurance that feels like a good deal to you, but if you don't, it's OK to make this a business decision and not a moral question of "good grownups get health insurance".
posted by mattu at 11:04 AM on May 16, 2013 [2 favorites]
I would certainly look into assistance programs. Also, note that you may have better assistance options in 2014 with the Affordable Care Act provisions.
High deductible sounds like a good idea in your case, if you have no important existing issues. (If you've not been officially diagnosed dysthimic, it's not part of your medical history, you don't need to mention it.)
Finally, I will be a little heretical and say that it is not necessarily irresponsible to go without health insurance. Health insurance can be unreasonably expensive.
(It is also true that one bad visit to the emergency room could be $200K--but you might be able to pay it off at $50.00 a month for the rest of your life, or just refuse to pay the bills and take the hit to your credit rating. Developing a chronic condition is (to me) a scarier scenario, but again you have the ACA rolling out in 2014--you can go buy the insurance then if you need it.)
You may be able to find health insurance that feels like a good deal to you, but if you don't, it's OK to make this a business decision and not a moral question of "good grownups get health insurance".
posted by mattu at 11:04 AM on May 16, 2013 [2 favorites]
I thought of some other things while I was making myself a cup of tea ... let me mention that I am not an insurance broker, but I am someone who has purchased health insurance individually (for myself and my family) in WA:
- If you don't require maternity coverage, it will save a lot of money. When I first bought insurance a few years ago, the difference was about $250/month. Since you are about a decade older than me than at the time I was buying insurance, the numbers might not be completely comparable, but I wanted to give you an idea. Maternity coverage is not the same as gynecological coverage - your health insurance in WA is required to cover gyn services.
- The depression thing is pretty much a non-issue in WA. When you apply for insurance, no matter the company, there are going to ask you to fill out a form that asks tons and tons of questions about health history. This is a form required by the state - insurers are not allowed to ask things not on the form, and it's my understanding that there's a limited number/type of conditions that they can reject people for. They have to do this because WA is pretty specific amount minimum requirements - insurance is more regulated here than in other states. In WA, insurers are required to provide a certain amount of mental health benefits. Of course don't disclose anything that you haven't been diagnosed with - but don't hide things because the lie can probably derail your application.
- As far as I can tell, unless you are in some certain very high risk category, your price for health insurance in WA is determined by the following 3 factors: age, gender, and smoking status. After that you're just comparing things like premium/deductible/coinsurance amounts. (Granted, that does add up to a lot of numbers to compare. And the coinsurance amounts can really add up if you need more than preventative care visits.)
- I have Regence and my plan is basically the same as my last employer-sponsored health plan. (Due to the aforementioned heavy regulation! Yay!) Dealing with Regence has been relatively easy, they pay what they are supposed to pay. There was a hiccup once with a doctor that changed practices, but they sorted it out very quickly for me. Some people love Group Health, others hate it. You get the idea.
posted by stowaway at 11:27 AM on May 16, 2013
- If you don't require maternity coverage, it will save a lot of money. When I first bought insurance a few years ago, the difference was about $250/month. Since you are about a decade older than me than at the time I was buying insurance, the numbers might not be completely comparable, but I wanted to give you an idea. Maternity coverage is not the same as gynecological coverage - your health insurance in WA is required to cover gyn services.
- The depression thing is pretty much a non-issue in WA. When you apply for insurance, no matter the company, there are going to ask you to fill out a form that asks tons and tons of questions about health history. This is a form required by the state - insurers are not allowed to ask things not on the form, and it's my understanding that there's a limited number/type of conditions that they can reject people for. They have to do this because WA is pretty specific amount minimum requirements - insurance is more regulated here than in other states. In WA, insurers are required to provide a certain amount of mental health benefits. Of course don't disclose anything that you haven't been diagnosed with - but don't hide things because the lie can probably derail your application.
- As far as I can tell, unless you are in some certain very high risk category, your price for health insurance in WA is determined by the following 3 factors: age, gender, and smoking status. After that you're just comparing things like premium/deductible/coinsurance amounts. (Granted, that does add up to a lot of numbers to compare. And the coinsurance amounts can really add up if you need more than preventative care visits.)
- I have Regence and my plan is basically the same as my last employer-sponsored health plan. (Due to the aforementioned heavy regulation! Yay!) Dealing with Regence has been relatively easy, they pay what they are supposed to pay. There was a hiccup once with a doctor that changed practices, but they sorted it out very quickly for me. Some people love Group Health, others hate it. You get the idea.
posted by stowaway at 11:27 AM on May 16, 2013
Individual insurance is very expensive because there is no union steward type person haggling for better rates. Also, there are not others to support the outlay for one person's care. Is your mother insured? Can you join her group?
posted by Cranberry at 1:13 PM on May 16, 2013
posted by Cranberry at 1:13 PM on May 16, 2013
I am a USAA member, and in the past year I contacted them about health insurance. What I found is that they aren't the insurer. The insurer is Assurant Health. Frankly, when I called the number that USAA gives members for Assurant Health I was a bit surprised -- they Assurant guy was not helpful and kinda acted like I was wasting his time. Not like USAA at all.
At any rate, I compared their policies with others, and went with BlueCross/BlueShield of Texas for an individual policy because I could get a better policy for less money. My stats are similar to yours, I pay about $250/month, and I have a $10,000 deductible. After the deductible is met, the next $5,000 are split 50/50. After that, the bills are paid by the insurance company.
So, that means I'm $12,500 in on deductible costs before they pay. This type of policy is not good for people who worry about paying the bill for a doctor visit, well-woman visit, medicine for colds, etc. This policy is good for people who need to insure themselves against financial ruin/bankruptcy should something really dire happen (cancer, hit by a bus). You might consider for yourself which you want -- insurance that also helps you set aside money for smaller costs like doctor visits, or insurance only against significant loss. The deductible I have is (I think) the biggest deductible they offered, and it's a good choice if you can afford it (but do remember that a deductible is annual, so you must be able to afford it for consecutive years if it were to come to that).
posted by Houstonian at 3:08 PM on May 16, 2013 [1 favorite]
At any rate, I compared their policies with others, and went with BlueCross/BlueShield of Texas for an individual policy because I could get a better policy for less money. My stats are similar to yours, I pay about $250/month, and I have a $10,000 deductible. After the deductible is met, the next $5,000 are split 50/50. After that, the bills are paid by the insurance company.
So, that means I'm $12,500 in on deductible costs before they pay. This type of policy is not good for people who worry about paying the bill for a doctor visit, well-woman visit, medicine for colds, etc. This policy is good for people who need to insure themselves against financial ruin/bankruptcy should something really dire happen (cancer, hit by a bus). You might consider for yourself which you want -- insurance that also helps you set aside money for smaller costs like doctor visits, or insurance only against significant loss. The deductible I have is (I think) the biggest deductible they offered, and it's a good choice if you can afford it (but do remember that a deductible is annual, so you must be able to afford it for consecutive years if it were to come to that).
posted by Houstonian at 3:08 PM on May 16, 2013 [1 favorite]
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posted by Capri at 9:07 AM on May 16, 2013