Self-insurance health opinions and challenges

[cute fuzzy bunny]

One last tidbit...your med insurance payments may be deductible on your tax return to the extent that it exceeds 7.5% of your adjusted gross. In my case it was.

[Peter]

So has anybody actually found an individual insurance plan that offers an HSA?

I've had an MSA since they were first introduced ... the new HSAs are basically the same deal, with less restrictive terms and conditions.

You don't have to have the insurance and the savings account under the same umbrella company. In my case, I have a Blue Cross health policy that meets the requirements, and the MSA is adminstered by Home Federal Savings. Home Federal has indicated to me that they will be doing HSAs as well, and that I can convert my MSA into an HSA.

So far, the arrangement has worked well. The BC plan gives me the negotiated rate, and doctor bills are effectively paid with pre-tax dollars.

Peter

[mykidslovedogs]

Originally Posted by unclemick

I haven't had any health insurance for ten years(single). Girlfriend(thru union retirement) and widowed mom(medicare plus supplimental).

I deliberately avoid American doctors - they can get someone else to pay their med school loans - and malpractice insurance. Foreign doctors don't overtest, overconsult. and over worry as much - American doc.'s in some ways are in as bad a bind as their customers.

Age 49-60 without any insurance is pushing the envelope and I've spent $200 over the years(hairline wrist fracture).

I don't recommend my path to anyone - one more worry about systemic risk to the portfolio.

I may do some insurance shopping this yr but I think most high deductible is capped at 10k which is too low.

World Insurance has a $25 K deductible, but the cost savings, IMO really isn't that much better than the $10K ded. Also, anything over a $5250K deductible for a single person is not going to be HSA compatible.

[mykidslovedogs]

Originally Posted by cute fuzzy bunny

Couple of interesting bits:
- Rack vs insurers rates. Some doctors will charge you the same rate as BC/BS does if you ask them. You can buy these cards for a hundred bucks or so that give you a list of doctors who will do this. Better still, go to the web site for the outfits selling the cards, look up the doctors in their "provider list" and see if one of them will do the work at the lower rate without the card. Fair warning, these may not be the very best doctors.

- Regarding the deductible at rack or insurers rate. I know BC/BS in california requires the doctors provide all service at BC/BS's negotiated rate. You pay the deductible but its at the lower rate.

One question in case someone has looked into it...I've heard that their are some groups (RVers, etc) that have banded together to obtain group coverage and by paying a fee to join, you can get into their coverage. Has anyone looked into this, what coverage areas do they have, and what are the rates like?

Association plans have rates similar to that of Group Insurance. The advantage is that they are guaranteed issue. The disadvantage, like with all guaranteed issue plans, the premiums are much higher than individual coverage.

With ALL PPO plan designs, you CANNOT be "balance billed" if you use an "in-network" provider. You've got to check the doctor directory before utilizing services. If you go outside the network, the bill for the "allowed amount" appiles to the separate, "out of network" deductible, and you get "balance-billed" above and beyond what the insurance carrier will not cover.