individual health insurance choices

[RJ732]

Hi, does anyone have an opinion on which is the best health coverage available? My company that I've worked for for the past 15 years just abruptly closed with no prior notice and left us all without Cobra -since there is no longer a group plan.

Any thoughts on the "basic and essential" plans? BCBS Basic & Essential Plus is quoted at $286 per month for a 48 year old (NJ) and appears to offer adequate coverage -what am I missing? or Are the standard plans worth the extra premiums? I would be interested in what others have chosen as I try to sort all this out.

I'm 48 M, live in NJ and no major health problems (unless a bad back counts) -thanks RJ

[Dawg52]

I chose a high deductible plan with Blue Cross. My thinking was I would self insure for the first 10k and save the difference on the lower ded plans. The plan does have doctor and drug copays. So if you can afford to partially self insure, might be a good way to go.

Here is a good source for quotes.

https://www.ehealthinsurance.com/ehi...UOTES+042106+1

[teejayevans]

Quote:

Originally Posted by RJ732 Hi, does anyone have an opinion on which is the best health coverage available? My company that I've worked for for the past 15 years just abruptly closed with no prior notice and left us all without Cobra -since there is no longer a group plan. Any thoughts on the "basic and essential" plans? BCBS Basic & Essential Plus is quoted at $286 per month for a 48 year old (NJ) and appears to offer adequate coverage -what am I missing? or Are the standard plans worth the extra premiums? I would be interested in what others have chosen as I try to sort all this out. I'm 48 M, live in NJ and no major health problems (unless a bad back counts) -thanks RJ

I'm the same age, went with United Healthcare for $500/quarter,
5K deductable, unlike BCBS, you can change states without
going through the application process, each BCBS acts as an
individual company.
TJ

[brewer12345]

Welcome to NJ. Now bend over...

The good news: your bad back, diabetes, crack habit and three artificial limbs cannot be used against you in whether you can get insurance or how much you will pay for it.

The bad news: anything like adequate coverage is outrageously expensive for anyone who is more or less healthy.

As for what you should do, I think you would be wise to read the fine print of each type of policy to determine how much you would be on the hook for if you had a long and expensive hospital visit. Then compare that sum to how large a loss you feel you can afford to take and choose your plan accordingly.

[Martha]

This link is to a booklet on buying health insurance. At the end of the booklet is a worksheet which is very helpful to use in comparing policies. http://www.healthinsuranceinfo.net/n..._Insurance.pdf

[walkinwood]

Quote:

Originally Posted by RJ732 Hi, does anyone have an opinion on which is the best health coverage available? My company that I've worked for for the past 15 years just abruptly closed with no prior notice and left us all without Cobra -since there is no longer a group plan. Any thoughts on the "basic and essential" plans? BCBS Basic & Essential Plus is quoted at $286 per month for a 48 year old (NJ) and appears to offer adequate coverage -what am I missing? or Are the standard plans worth the extra premiums? I would be interested in what others have chosen as I try to sort all this out. I'm 48 M, live in NJ and no major health problems (unless a bad back counts) -thanks RJ

I just got my own individual health coverage in NJ through Horizon BCBS. I decided AGAINST the "basic & essential plus" plan because there is NO maximum annual out of pocket limit. They will pay for 90 days in a hospital and you're on your own after that.

I chose to go with the HMO with deductable ($2500) and Co-Insurance (50%). It has a $5000 max annual out of pocket and a $40 Co-pay to see your primary physician. My main considerations were - a) Protect us against going broke if we got seriously ill, and b) get the lowest premium possible while meeting point a. My policy is around $330/mo.

All the best.

[firewhen]

Walkinwood,

Did you look at Amerihealth? Their preferred plan would cost more than your Horizon plan, but there would be no deductible or coinsurance. How did you go about your research on making a selection? I have looked at ehealthinsurance.

We are also in NJ. As I understand, all companies have to pick us up, just at a pricey rate.

[Bikerdude]

I would check out a high deductible 'Health Savings Account'. Since you are currently healthy you could make out with this type of policy due to the favorable tax treatments. Try to find one that has covered preventative care.

[brewer12345]

Quote:

Originally Posted by Bikerdude I would check out a high deductible 'Health Savings Account'. Since you are currently healthy you could make out with this type of policy due to the favorable tax treatments. Try to find one that has covered preventative care.

Sadly, not available in the individual health insurance market in NJ.

[. . . Yrs to Go]

Definitely read the small print! Some of the "Basic & Essential" plans don't include big ticket items like Chemotherapy, transplants, etc. If you wake up one day with cancer, you'll probably think chemo is not only basic but essential. Considering it is these types of things I want insurance to cover (not the nickel and dime stuff) I'm going to go with a more comprehensive plan when I leave my firm.

I've also considered leaving the state to avoid the likely $12K+/yr insurance bill for me and my wife.

[Bikerdude]

Quote:

Originally Posted by brewer12345 Sadly, not available in the individual health insurance market in NJ.

Bummer.

[walkinwood]

Quote:

Originally Posted by firewhen Walkinwood, Did you look at Amerihealth? Their preferred plan would cost more than your Horizon plan, but there would be no deductible or coinsurance. How did you go about your research on making a selection? I have looked at ehealthinsurance. We are also in NJ. As I understand, all companies have to pick us up, just at a pricey rate.

I used eHealthinsurance to do my research, as well as links in the health section on this board. A good site for data on your rights in NJ - Health Insurance and Coverage Help for Consumers Everywhere

I did not research Amerihealth for two reasons : 1) the summary of the Amerihealth plan said that there is no annual out-of-pocket limit, and b) my neighbour and doctor are customers and pleased with Horizon BCBS service.

I did a quick review of the plan a few minutes ago, and it looks good. I suggest that you ask all the difficult questions about chemotherapy coverage, number of days in hospital covered etc. Ask for the written documentation. I'll probably do the same when I get some time since it could save us some money. Thanks for bringing it to my attention.

You are correct - the companies have to take you on. However, if you are not "HIPPA eligible", they can institute a waiting period for treatment of pre-existing conditions for a max of 6 months (I'm pretty sure about this, but please check)

All the best.

[pedorrero]

If you can get BCBS for $286/mo. for a 48-yo, that would be excellent in FL. I am paying close to double that (46-yo), but I have a 100% rate increase (Guaranteed Issue) due to a pre-existing condition. Of course, I am not aware of perhaps crappy limitations a NJ policy may have. The short answer seems to be, if you are in good health, obtain a cheaper policy like the savings account, or even move to another State (most of them!) that don't mandate insurance to all comers. In other words, if you are a "cherry" (excellent health), get your healthy ass some renewable, affordable insurance while you still can (be "cherry picked"). Just because America's health care system is broke (it is), doesn't mean you have to be.