Health Insurance for ERs in MA

[nun]

I'm going to be ERing in Massachusetts in a couple of years time and I'll be out on my own for health care. I've looked at the state "Connector" site and can get a good insurance with no deductible and low annual maxes for $400/month. Now I'm thinking about vision and dental. Has anyone experience of buying these? How much do they cost? Are they any good?

I'd be interested to hear your stories and experiences of buying and using these insurance products in MA.......and other states too

[TromboneAl]

Re vision and dental -- if you try to use insurance to make things cheaper, you will lose. If you use insurance to prevent a catastrophic cost event, you will win.

[ziggy29]

Quote:

Originally Posted by TromboneAl Re vision and dental -- if you try to use insurance to make things cheaper, you will lose. If you use insurance to prevent a catastrophic cost event, you will win.

I think dental insurance that isn't employer-subsidized is pretty much a loser. Most of them are capped at $1000-1500 a year anyway, so if you're capable of self-insuring to that amount I haven't seen any dental plans not subsidized by an employer which are worth it.

[nun]

Quote:

Originally Posted by ziggy29 I think dental insurance that isn't employer-subsidized is pretty much a loser. Most of them are capped at $1000-1500 a year anyway, so if you're capable of self-insuring to that amount I haven't seen any dental plans not subsidized by an employer which are worth it.

That's what I figured. Dental insurnce cost $50 a month and had that low max benefit. Do most folks just pay for dental and vision out of thir own pocket?

[samclem]

Quote:

Originally Posted by nun That's what I figured. Dental insurnce cost $50 a month and had that low max benefit. Do most folks just pay for dental and vision out of thir own pocket?

I think so. There are "discount plans" (here's a site where you can find some for the area to whch you'll be moving) that allow you to take advantage of pre-negotiated rates for various services, but you'd probably want to check out the quality of the dentists who belong to these plans. It's not a bargain if you save $20 and get a dentist like thefed has.

[dgoldenz]

Quote:

Originally Posted by TromboneAl Re vision and dental -- if you try to use insurance to make things cheaper, you will lose. If you use insurance to prevent a catastrophic cost event, you will win.

I think this hits the nail on the head. You'd be better off negotiating your own cash prices. Some people don't feel comfortable doing that though, so sometimes a discount plan that pays for your preventative care can make sense if it's cheap enough. As an example, Blue Cross here has a $150/year plan that gives discounts for dental work, but pays 100% of preventative cleanings/xrays/etc if you choose an in-network dentist. A regular cleaning is usually $125-150 anyway, so if you use it twice per year, you'd come out ahead.

[lemming]

Are you sure about the $400 premium. Is MA insurance allowed to underwrite each person individually. ? That's the kicker in a lot of insurance -the quoted price is only for some mythical being with a perfect background.

If there really is a universal coverage group I need to think about heading North.

[dgoldenz]

Quote:

Originally Posted by lemming Are you sure about the $400 premium. Is MA insurance allowed to underwrite each person individually. ? That's the kicker in a lot of insurance -the quoted price is only for some mythical being with a perfect background. If there really is a universal coverage group I need to think about heading North.

Massachusetts rates are guaranteed-issue with no pre-existing conditions. Must be a younger person to be paying "only" $400/month in Mass.

[gettingthere]

Here is a site you can use to explore the options available:
https://www.mahealthconnector.org/portal/site/connector/

I found a number of plans in different tiers, for a single person mid-50's in my end of the state (west):

Low premium. Most have deductibles and co-payments. Prescription drug coverage included. 4 plans $426.16 - $541.08/mo

Moderate co-payments. Some have no deductible. Prescription drug coverage included. 7 plans $526.57 - $763.44/mo

Low co-payments. No deductible. Prescription drug coverage included. 4 plans $759.12 - $1,002.20/mo

These are the normal-price plans. They offer assistance to persons uncer a certain income level.

I think there is fully paid coverage for really low-income persons. But I think those are a different set of plans, not the ones listed above.

[gettingthere]

Quote:

Originally Posted by nun I'm going to be ERing in Massachusetts in a couple of years time and I'll be out on my own for health care. I've looked at the state "Connector" site and can get a good insurance with no deductible and low annual maxes for $400/month. Now I'm thinking about vision and dental. Has anyone experience of buying these? How much do they cost? Are they any good? I'd be interested to hear your stories and experiences of buying and using these insurance products in MA.......and other states too

nun - I am also in Massachusetts - just started looking at the plans offered recently. Dig down into some of the detailed descriptions - some appear to offer at least preventative dental coverags and anual vision exams.

[nun]

Quote:

Originally Posted by gettingthere Here is a site you can use to explore the options available: https://www.mahealthconnector.org/portal/site/connector/ I found a number of plans in different tiers, for a single person mid-50's in my end of the state (west): Low premium. Most have deductibles and co-payments. Prescription drug coverage included. 4 plans $426.16 - $541.08/mo Moderate co-payments. Some have no deductible. Prescription drug coverage included. 7 plans $526.57 - $763.44/mo Low co-payments. No deductible. Prescription drug coverage included. 4 plans $759.12 - $1,002.20/mo These are the normal-price plans. They offer assistance to persons uncer a certain income level. I think there is fully paid coverage for really low-income persons. But I think those are a different set of plans, not the ones listed above.

I'm 48 and a high end silver plan from Neighborhood Health with no deductible and a max out of pocket expense of $2000/year was $387/mth. MA is now looking at containing costs so I hope that the cost will not increase too quickly.

[nun]

I just realized that I might actually qualify for the MA Commonwealth Care program for those people with low incomes. If my income is, say $30k/year, I'll be able to get a good plan (no deductible, no co-insurance, and with max co-pays per year around $2000) for $116 a month.

I'd feel a bit bad about applying for it as I'll have a fair amount of savings and no mortgage and so my costs will be low allowing me to live well on what would normally be a low MA income. There is no mention of the state taking net worth into consideration, just gross adjusted income. Does anyone know if someone with $1M in the bank, but only taking $30k / year in income would get Commonwealth Care....

[ziggy29]

Quote:

Originally Posted by nun I'd feel a bit bad about applying for it as I'll have a fair amount of savings and no mortgage and so my costs will be low allowing me to live well on what would normally be a low MA income. There is no mention of the state taking net worth into consideration, just gross adjusted income. Does anyone know if someone with $1M in the bank, but only taking $30k / year in income would get Commonwealth Care....

Shh -- as someone who's increasingly looking to engineer an asset rich/modest income lifestyle in retirement, don't draw attention to us!