Anybody? Is there hope?

Adam

I'm surprised no one has responded. I just discovered this forum tonight. I can tell you're younger than me, but i'm looking for answers also. Tonight, I posted the following over at insure.Com. I'll let you know if I get a worthwhile response:

i'm 57, female, and have been self-employed since the mid-80's. Typically I buy into a health insurance plan (ppo) at a reasonable rate and after 6 months to a year, the rate starts regulary going up. I'm always told by the insurance company that the reason is because health insurance costs have gone up and the same increases are being applied to all people in my area/group.

No doubt rates were going up, but then when I would go shopping again for health insurance I was able to get the cost down, usually to around the same price I started at a year or two year earlier. Strange.

It became clear to me that this was a racquet. Get the customer in, take their money, start raising their rates to the point where they will want to leave - basically keep them for 2-3 years, which reduces the insurance company's risk. I've had this racquet confirmed by a knowledgeable insurance agent who actually teaches in a college.

Out of all this, my greatest fear has always been that I would have a health problem and I could no longer change unless my problem was excluded either temporarily or permanently. All the while, my health insurance costs escalate every six months.

Well, i'm there. I have had a mildly abnormal pap for the last year. But, no insurance company is going to cover this and all the while my rates are climbing. My monthly payment has gone from $232 in 10/01 to $580 starting 9/04. If my figures are correct, that's about 150% increase. Does it seem reasonable that health costs have increased 150% in 3 years?

I hear the politicians talking about making health insurance more affordable for employers, but I am the employer and employee (i incorporated about 2 years ago). If, and that's a big if, anything gets changed by washington, could this benefit me in any way?

At this rate of increase, i'll be paying $1,000 per month in a couple of years.

I wouldn't qualify for medicaid because I make too much money, but I don't make enough to afford these increases for much longer. I had to put the balance of my car loan on my home equity line of credit to decrease my car payments and offset medical insurance increases.

Why is washington doing nothing about what is to me an obvious rape of the consumer by the insurance companies?

Is it possible I could get coverage at a better rate thru something like nafe (nat'l association of female executives) or similar and still have my pre-existing condition covered?

This forum does not get a lot of traffic and is loosely monitored. Unfortunately, most of the traffic is from people pitching discount health plans that are extremely overpriced.

I do check in from time to time and offer what assistance I can.

My experience, based on 30 years in the industry, is most people have no clue how to buy health insurance. Either they are constantly shopping, looking for the next "deal" or they buy coverage they don't really need.

I can't really comment on adamo regarding your premiums. My guess is you have overbought in the coverage area, thats why your premiums are high.

I am 54 and cover my wife and college age daughter for $220 per month. We live in atlanta, a relatively high cost area but I am still able to keep the premiums reasonable. We have had the same carrier for 2 years.

As for cynthia, if you think this industry is a "racket" then you will only look for ways to justify your opinion. Seems you already have.

By jumping around you are constantly subjecting yourself to new waiting periods and pre-ex terms. This will eventually trip you up (if it hasn't already).

As for the "knowledgeable agent", well either he didn't do a good job of explaining things or you didn't do a good job of listening.

Rates go up for a number of reasons not related to your particular situation. Overall, a new entrant who has just gone through the underwriting process gets a better rate than one who has been in the pool for 3 - 5 years. That stands to reason.

Other explanations for your frequent increases can best be attributed to contractual changes due to age and your proclivity for shopping for the lowest rates. Carriers do manipulate their market share by introducing below market rates on new product lines and then adjust accordingly. But if you pick a good carrier from the start you will be subject to fewer fluctuations in premium.

Take care,

bob vineyard, clu

Bob, thanks for your response. It's been awhile since I posted. I'm a little unclear by what you mean when you say I may have 'overbought'. I've looked into the local health insurance market and there seem to be very few 'non-group' providers. I've been with the same company 'blue cross/blue shield' for the last 12 years, I have a plan they call 'hmo blue' and I have no prescription coverage and I pay, as mentioned above, over $750/month. How on earth do you have a premium of $220/ month for your family? Is it 'non-group'? Do you have a deductible? Is it just that insurance is cheaper in atlanta than boston?

Thanks


adam

Hi bob! My name is sandy, I am curious too! With this insurance being through employment does the employer pay for some of your family's medical insurance and you pay the $220.00 per month? What type of deductibles and out of pocket do you pay and your co-pays, what about your medications. I better quit while I am ahead, I may have already asked too many questions, like I said before, I am just curious and you did say this was through an employer.
I was with b/c & b/s of or and I had to pay $482.00 per month because I am classified as high risk with my medical situations but they would be going to approximately $550.00 per month after the first of the year. I now have medical insurance thru my employer but I still have to pay a lot of out-of-pocket expenses. But so far it has been cheaper than the $482.00 per month(knock on wood).
Sincerely,
sandy

Adamo -

by overbuying I mean you have (probably) bought coverage you dont need. That happens often, especially with those who left the corporate world of very low (or no) deductibles when they pick coverage on their own.

Many of the plans offered (at least in ga) have doc & rx copays to help through the everyday items. The major expenses are then subject to a deductible and coinsurance. Most people dont need a $500 deductible and would be quite safe with a $2000 deductible or even higher. The savings can be 30% or more.

In my case I have a $10,000 deductible with 100% coverage above that threshold. We rarely go to the doctor and are not on any maintenance meds. The out of pocket to us is minimal but I have protection in case of a major claim.

Sure $10,000 would set us back but not as much as paying $600 per month for coverage I will rarely use.

Bob vineyard, clu

Lisa, why would you suggest a discount plan as a replacement for health insurance?

Bob vineyard, clu

Let me make one thing clear, I would never encourage someone to substitute a discount plan for an insured plan . . . But I was curious about your post and wondering what kind of response I would get.

Anyone who replaces an insured plan with a discount plan needs to have some serious asset protection planning. When a major claim occurs their only escape will be personal bankruptcy.

Discount plans, especially dental plans have some benefit to those in metro areas where the patient does not have an existing relationship with a provider. Dental networks typically have less than 20% penetration into the provider market and most providers that do agree to discount their services are either new formed practices or those who have had difficulty establishing a client base.

Most providers in a dental network are inexperienced.

Given the pricing structure of ameriplan for their current limited benefit plan I will be curious to see how the medical plan fares. Frankly, I am surprised the roll out hasnt occurred before now. Their alliance with phcs was announced quite some time ago.

Bob vineyard, clu

What really gets my goat is that some(caps) of these people on welfare and some(caps) of these people that are so called "disabled"(unable to work, hah!), that are in better shape than some of us working people get 100% coverage for medical, dental, vision, hospitalization, food stamps, hud, breaks on utilities, phone and everything else, making more money than some of us working people, some are working under the table, living tax free and we have to pay for them and ourselves, and most of these people don't have to pay a dime. I realize that this is the system and politics but something needs to be done!
Look at all the money we have given to all the other countries, and iraq, our own country, it is going to h*e*c*k!
I realize that this is kind of off the topic but thanks for letting me vent anyway!
I realize that this is called "the land of the free," but it is only free for some!
Sincerely,
sandy

Admo,

i would recommend a health savings account. These are increasingly populare and can be very beneficial to your situation. As bob mentioned, you can get a high deductible plan with 100% coinsurance. So, your premiums are lower and of course being self employed you can get the write off. Also, you can place 100% of your deductible (maximum of $5,000 I think) into a seperate savings account gaining interes tax deferred. You can also spend the money out of this account (liberaly) on anything to do with your health tax free! This should help you out on both ends. Please see your local broker for more information.

P.S.

You do not lose the money at the end of the year. As I said, it gains interest and at 70 years old or when you withdrawl social security, you must withdrawl as income like an ira. If you withdrawl early for a non-medical purpose, you will face a 10% irs penalty.

Jason

I am currently checking out health insurance for my small biz that is growing. I also have a regular day job so I am a pretty busy person all around. Finding good health coverage is really the last hurdle to me jumping into my biz full time. Where I currently work which is about a 500 person facility the insurance is top notch and I pay nothing. Unfortunately if I stay there i'll being saying "i wish I had tried to get out on my own when I could". I guess I would rather try and fail than not try at all.

So anyway, I ran across this thing called an archer msa but I can only find sporadic info on it. Does anyone use this and are there different types. Also my business is computer illustration so the odds of me getting hurt on the job may only amount to me getting a spranged thumb on my trackball. Is there any insurance tailored to computer jocks like me or are all self employed people lumped together. If I get placed in the same catagory as the bearing strait crab fishermen (apparently the most dangerous job in the world) i'm thinking that's not quite fair. Any info from you folks out there would be greatly appreciated.

Jon

The law making msa's possible was allowed to sunset 12/31/2003. The replacement is much broader. Talk to a qualified agent about hsa's.

As to your question on otj injury, that is a wc question. Depending on where you live, wc may not be an option (or required). In ga you are not required to have wc until you have 3 employees.

Most health insurance plans will include/offer 24 hour coverage if you dont have wc.

Bob vineyard, clu

Hello

Procardabra -

your discount plan is not insurance. Apparently no one has explained to you the kind of trouble you can get into promoting it as such. When you pay some hefty fines and are sued by those who bought the card because of your misrepresentation, maybe you will learn.

I note you have been chastised on other forums for soliciting. Guess the message has not registered yet.

Cynthia: I fully understand your frustration. I had a policy with mutual of omaha for twenty years (major med) and never made a claim. In dec. -03 they termianted all individual major med policies and I have been a nervous wreck ever since. I have parkinson's disease so I am unable to find a company that will insure me. I am 61 years old and hope and pray that I can avoid a major hospitalization. I am actually anxious to reach 65. Dee

Those who are having problems with high deductibles should consider supplemental insurance. It has relatively low premiums, pays cash to the policyholders based on fixed amounts for specific services, and is guaranteed non-cancellable with some suppliers.

It is not designed to be all things to all people - just a little help. There are hospitalization policies, accident, cancer, heart attack/stroke, etc. There are some qualifying questions on some of the policies, but it is worth a little research.

I hope this idea helps someone.

I am looking for a high ($25,000) deductible policy. Any suggestions? Ty.

Whatever you do, do not purchase any health insurance from an organization called "national association for the self-employed", and also do not purchase anything from mega life insurance company and midwest life insurance company.

Ask around. You'll find out why.

Go to the big names, such as fortis, golden rule, world, etc. Real insurance.

I was rejected by fortis because of an existing condition. I have given up on getting any kind of coverage.