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'[OT] Health insurance options for the self employe'
2008\01\17@194934 by David Novak

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For those of you who are self employed in the USA, I would like some advice
regarding health insurance. I am currently my company's only employee and I
need to purchase a family health insurance plan.

I have the following questions:

1.) From the research that we have performed, it appears that group coverage
is typically a better deal than individual. I think this is especially true
given that my wife has diabetes. Is this perception correct?

2.) Can you recommend an insurance company.

3.) We've learned about PEO's and they seem to be a good idea. Can you share
your experiences with PEO's?

4.) I've read that it is sometimes possible to become part of a group
coverage plan through trade associations. Can anyone suggest a trade
association that offers health insurance?

5.) How have you solved the health insurance dilemma?

Thanks,
David

2008\01\17@200626 by Chris Smolinski

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>For those of you who are self employed in the USA, I would like some advice
>regarding health insurance. I am currently my company's only employee and I
>need to purchase a family health insurance plan.
>
>I have the following questions:
>
>1.) From the research that we have performed, it appears that group coverage
>is typically a better deal than individual. I think this is especially true
>given that my wife has diabetes. Is this perception correct?

It is a better deal in that you'll be able to get insurance. Your
chances of getting individual health insurance with diabetes are
pretty close to zero.

>2.) Can you recommend an insurance company.

It depends on which companies are licensed for your state. I use
UnitedHealthcare (I am in Maryland).

>3.) We've learned about PEO's and they seem to be a good idea. Can you share
>your experiences with PEO's?

Do you mean PPO? I'm in an HMO myself, although UH offers PPOs also.
They tend to charge more for less coverage IMHO.

>
>4.) I've read that it is sometimes possible to become part of a group
>coverage plan through trade associations. Can anyone suggest a trade
>association that offers health insurance?

I've heard that, but haven't tried, myself.

>5.) How have you solved the health insurance dilemma?
>

I got a group plan, Maryland used to require insurance companies to
offer group coverage to the self employed. They no longer do, but I
am grandfathered in. That's the primary reason I stay with UH, even
though my rates go up about 20% a year.

--

---
Chris Smolinski
Black Cat Systems
http://www.blackcatsystems.com

2008\01\17@201827 by Lee Jones

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> 5.) How have you solved the health insurance dilemma?

We pay to upgrade to family coverage through the health plan
offered by the company where my wife works.

                                               Lee Jones

2008\01\17@203404 by James Newton

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I like Kaiser.

They run the numbers differently: They don't pay some unknown doctor a few
hundred for every month you see him like the regular HMO's, they just pay
their doctors salaries. So the standard HMO doctor makes MORE money if you
stay sick and keep coming to see him every month. The Kaiser doctor makes
the same money, AND he gets a bad rating because they track the fact that
you keep coming back.

And that also applies to preventative medicine. They pay for your classes to
help you stop smoking. Or to loose weight. Or to eat better. And so on. They
do it because they want you to stay healthy: Then they make more money.

Sometimes they push their doctors a little hard. Sometimes they get doctors
who don't speak English really well. But everyone at Kaiser really, really
wants you to stay healthy. That HMO doctor wants you to try a different pill
and come back to see him next month.

True story: My prior employer was a small shop and I had a lot of pull with
management. We were on some HMO (Aetna I think?) and a coworker was having
really bad problems with allergies. Really bad. Missing work. Going to the
local ("just around the corner, it's so convenient") doctor who gave her a
different anti-histamine every single month. This went on for 5 or 6 months.
Some sort of helped, but she also had to deal with side effects. When the
time came to renew, I threw a fit and demanded that we move to Kaiser, and
we did. My coworker was pissed 'cause now she had to drive 20 minutes to the
Kaiser hospital. But the FIRST appointment, they scheduled an allergen test
and found out she was allergic to grass...  They told her to A) stop
drinking those wheat grass drinks she liked so much B) hire a worker to mow
her lawn and stay away from it C) avoid contact with anything grass like.
Suddenly, no more allergies. No drugs. No doctor visits. Done.

Sadly, my current employer has a daughter who has more pull at the company
than I do, and couldn't recognize a good deal if it hit her in between the
eyes. So now we are on Blue Cross PPO and you know what I do? I avoid the
doctor. I started treating my medical issues myself. Luckily Zantac is
available OTC.  My wife went and was put on a drug that caused her so many
side effects she is just now getting over it months later. The doctor
specifically told her that the side effects were mild and she could easily
stop taking it. In fact, even the mfgr says you should taper off VERY (as in
over months) slowly due to the intense headaches, dizziness and vomiting
caused by withdrawal. The doctor didn't give a crap; she just wanted that
once a month meds management appointment.

Now we are stuck with the public emergency room with 4 hour waiting times
because they are legally required to service every bum in the county. Even
if I had to drive a half hour to the Kaiser Emergency room, I knew I was
going to get seen quickly because they only serve Kaiser patients.

If I could afford Kaiser outside the company coverage, I would do it in an
instant. They aren't fantastic, but they are so much better than the rest.

What ever you decide, look into how the doctors and other providers get
paid. Are they rewarded for keeping you healthy? Or are the rewarded for
treating you?

--
James.

{Original Message removed}

2008\01\17@220926 by Gordon Williams

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I live in Canada where the medical insurance is provided by the province
through our taxes.  Many people whine about the taxes we pay and the medical
services we get.  IMHO it is good value for money, on the whole - not
perfect but good.  Both my wife and I are self-employed and with two kids I
thank God that we don't have to go through this process.

Gordon Williams

{Original Message removed}

2008\01\18@023615 by Dario Greggio

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Gordon Williams wrote:

> I live in Canada where the medical insurance is provided by the province
> through our taxes.  Many people whine about the taxes we pay and the medical
> services we get.  IMHO it is good value for money, on the whole - not
> perfect but good.

sounds like "Sicko" :-)
(same in Italy of course)

--
Ciao, Dario

2008\01\18@041506 by Alan B. Pearce

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>> I live in Canada where the medical insurance is provided by the province
>> through our taxes.  Many people whine about the taxes we pay and the
>> medical
>> services we get.  IMHO it is good value for money, on the whole - not
>> perfect but good.
>
>sounds like "Sicko" :-)
>(same in Italy of course)

and the UK NHS (National Health Service) though with the number of cases of
MRSA occurring it seems more like the National Unhealthy Service at the
moment. But I do have to say that my dealings with it have been fine, but
then I haven't needed to stay in hospital here.

2008\01\18@172341 by alan smith

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some states have sponsored health plans....for those who are not insurable or whatever.  Check with the state health dept

Lee Jones <spam_OUTleeTakeThisOuTspamfrumble.claremont.edu> wrote:  > 5.) How have you solved the health insurance dilemma?

We pay to upgrade to family coverage through the health plan
offered by the company where my wife works.

Lee Jones

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