(Closed) For those who pay for your own health insurance, what do you have?

posted 4 years ago in Wellness
Post # 3
Hostess
23790 posts
Honey Beekeeper
  • Wedding: September 2011

@everyheart:  It’s been a couple of years since I was paying for my own health insurance, but I thought I’d bump your thread in hopes that you get more current responses! 🙂  Before DH and I got married, I was on my own insurance for about a year and a half through Blue Shield – I can’t remember exactly what plan it was or how much I paid for it, but it wasn’t too bad.  I would check out their plans here and request a quote:

https://www.blueshieldca.com/bsca/find-a-plan/health-plans/individual-family/home.sp

Post # 4
Member
9145 posts
Buzzing Beekeeper
  • Wedding: November 2013 - St. Augustine Beach, FL

Only advice is to avoid Humana because I couldn’t find any doctors who took it in my area.  Definitely try to get Blue Cross/Blue Shield or Aetna or United Healthcare.

When I shopped around a few years ago I was able to find basic high deductible policies for under $80 a month, however, those were without maternity (pregnancy) benefits.  Policies with maternity benefits were well over $180 a month.  Catastrophic policies ran around $40 a month but covered pretty much nothing unless you ended up with a major hospitalization over $10,000.

Every provider will offer you an affordable plan but they will have variable copays and deductibles.  The best thing to do is write down how often you go to the doctor each year (regular doctor for check up, sick visit(s), and OB/GYN for well woman visits) and any regularly prescribed medications you are on.  Are you being treated for any major or chronic illnesses?

Take into consideration whether you could afford to pay a deductible before receiving any non-emergency services (ex: CT scan for kidney stones could be covered under a copay or a $500+ deductible; could you afford to pay the deductible?)

I have a $250 deductible and after I pay that my insurance covers procedures at 80/20 (they pay 80% and I pay 20%); in-office procedures however are generally covered under my $25 office copay.  Recently, I had a bad Pap ($25 copay) which led to a colposcopy ($25 copay plus cost of biopsy reading by pathologist which fell under my deductible) then to a LEEP ($25 copay plus cost of procedure under my deductible plus cost of biopsy reading by pathologist which also fall under my deductible.)  It’s difficult to advise some which plan is best for them because everyone’s medical issues (and potential diagnoses) are different.


Why don’t you run some plans and then post the details for us to discuss pro’s and con’s of the different plans?

Post # 5
Member
1423 posts
Bumble bee
  • Wedding: May 2009

I’m in the same boat, so I’m interested in responses — this is the first time I’ll ever be buying insurance on the open market.  I never thought I would not have a job without insurance.

I’m finding that most policies are around $150/month without maternity; about $300 with, with pretty high deductables ($2500-$5000).  In my state it’s BCBS or nothing — it’s about the only major insurer (the free market my ass!!).  I also can’t figure out what maternity coverage covers and whether it would be worth it.  I’ll have to call.

Keep in mind that what you pay out of pocket will be more than the deductable.  Your insurance company will have a magic number for the allotted amount for a procedure, and only that amount is applied towards your deductible.  For instance, you might pay $250 for a test, but only $200 goes to the deductible.  The same goes for what they pay when your insurance kicks in.  To use the same example, they will pay 80% of the allotted $200, not 80% of the $250 you were charged. 

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