Individual Health Insurance : CO, WA, OR

[walkinwood]

We are considering three states for a possible move in the next couple of years - CO, WA, OR. I would appreciate it if you could share your knowledge and experience of Individual Health Insurance in these 3 states.

We are in good health and currently have individual health insurance in NJ.

I have been to eHealthInsurance and got the quotes. I am currently reading the descriptions on healthinsuranceinfo.net. But would like to see if there is more information out there - web sites, articles, forums etc.

Thank you.

 

[kevink]

Colorado is my home state and I've spent countless hours researching options. I highly recommend this web site and company:

Colorado Health Insurance Insider

They are Colorado only so far better info on the companies, their complaint ratios and service and other options than ehealthinsurance and they are quick to respond to email and calls. Very, very good service - a rarity.

Good luck with your search!

Kevin

 

[calmloki]

We are in Oregon and are fairly recent converts to Kaiser Permanente. Have been very impressed with their service thus far, which included some fairly spendy checking on the ol' ticker. They serve Oregon and California and I think part of Washington. They don't serve AZ or Utah, which we are interested in. Don't know about Co.

 

[ziggy29]

We are in Oregon and are fairly recent converts to Kaiser Permanente. Have been very impressed with their service thus far, which included some fairly spendy checking on the ol' ticker. They serve Oregon and California and I think part of Washington. They don't serve AZ or Utah, which we are interested in. Don't know about Co.

We had Kaiser when we lived in California. There were some shortcomings and limitations, but overall I liked it. One of the best things about it was the lack of dealing with the insurance bureaucracy and the lack of claim forms; if a Kaiser doctor indicated something was medically necessary it would be covered and you wouldn't have to deal with any insurance hassles. At least that's how it was up to a few years ago.

 

[RonBoyd]

I will defer to Kevink as we have never had Colorado-based health insurance. Nevertheless, when I went through that terrible experience of deciding which of the dozens of Medicare plans to take when I turned 65, I found the Colorado Division of Insurance to be the most valuable resource of all. This was particularly true when speaking on the telephone with them.

 

[walkinwood]

Thank you all for your comments.

In looking at insurance policies in CO, WA & OR in particular, I found that most had a $2M lifetime cap. In NJ, most policies have no lifetime cap. (In WA & OR, I couldn't find any with no lifetime cap)

Does this bother you? What is the consensus on the lifetime cap issue. Is $2M a safe amount Obviously there's always the chance that you'll go over, but what kind of disease would cause that?

I found that policies are much less expensive in all the 3 states than in NJ. NJ is a community rating state, so as long as you're HIPPA compliant, insurance companies cannot deny you coverage or charge you more based on prior medical history. Since the individual insurance market is quite small here, the premiums are quite high. We pay $740/mo for a HMO with $40 co-pays, deductibles ($5000) and coinsurance.

 

[haha]

Does this bother you? What is the consensus on the lifetime cap issue. Is $2M a safe amount Obviously there's always the chance that you'll go over, but what kind of disease would cause that?

In America? Infected hangnail could do it.

Ha

 

[dgoldenz]

I believe WA is also a guaranteed-issue state, not sure about OR. CO will probably have the lowest premiums of the three you're looking at. $740/month for an HMO with $40 co-pay, $5k deductible, plus co-insurance is pretty expensive. Remember your out-of-pocket maximum with a plan like that could be well over $10k. I would take a look at the HSA plans available to you to limit your max out-of-pocket expense to $7k or less and reduce your premiums. Don't know what the market is like in any of those states or NJ, but the principles remain the same.

 

[Life_is_Good]

Wife (53) and I (48) have Blue Cross/Blue Shield in Oregon. Our monthly premiums combined are under $500 monthly. I think the deductible is $5K with $30 copays.

Strange thing on the pricing....

It was cheaper to purchase individual policies for each rather than a single policy which insures both. I believe it has something to do with different rates based on age. Maybe under the single policy, they charge both at the higher aged policyholder? I don't know.

 

[dgoldenz]

Wife (53) and I (48) have Blue Cross/Blue Shield in Oregon. Our monthly premiums combined are under $500 monthly. I think the deductible is $5K with $30 copays.

Strange thing on the pricing....

It was cheaper to purchase individual policies for each rather than a single policy which insures both. I believe it has something to do with different rates based on age. Maybe under the single policy, they charge both at the higher aged policyholder? I don't know.

Kaiser also charges rates based on the oldest policyholder, along with some other BCBS.

 

[kevink]

We're in the same age range (53 and wife is 46). Have never thought to apply for separate policies, but I looked into ultra high deductible plans through the web site I mentioned earlier and also ehealthinsurance.com. Assurant Health was the lowest, with I think a 10K individual/20K family deductible; United was almost the same but with 15K deductible each (!). 2M limit for Assurant, I think 5M for United. Premiums were just over $200 a month total. You can buy accident insurance on top of that for around $50 a month that covers up to 10K per person with a $100 deductible to deal with commonplace cuts and scrapes.

Much, much cheaper than the other figures mentioned in this thread, but how long before they "pull a California" and up premiums 39% or more in one year is anyone's guess. How anyone can afford actual (routine and preventive) health care after paying for catastrophic insurance is beyond me. What a country.

 

[Gotadimple]

Much, much cheaper than the other figures mentioned in this thread, but how long before they "pull a California" and up premiums 39% or more in one year is anyone's guess.

Washington is a prior approval state, unlike California. So, the insurer submits a rate change to the state and cannot begin to use the new rates until they are approved. That doesn't mean the carrier couldn't get a 39% rate increase, it just means it's harder, as opposed to what happened in California.

-- Rita

 

[hobbes44]

I believe Kaiser in Washington is only at the bottom of the state, in Kelso and Vancouver.
If you are looking at the Seattle area that is a long drive.

 

[dgoldenz]

We're in the same age range (53 and wife is 46). Have never thought to apply for separate policies, but I looked into ultra high deductible plans through the web site I mentioned earlier and also ehealthinsurance.com. Assurant Health was the lowest, with I think a 10K individual/20K family deductible; United was almost the same but with 15K deductible each (!). 2M limit for Assurant, I think 5M for United. Premiums were just over $200 a month total. You can buy accident insurance on top of that for around $50 a month that covers up to 10K per person with a $100 deductible to deal with commonplace cuts and scrapes.

Much, much cheaper than the other figures mentioned in this thread, but how long before they "pull a California" and up premiums 39% or more in one year is anyone's guess. How anyone can afford actual (routine and preventive) health care after paying for catastrophic insurance is beyond me. What a country.

What state are you in?

 

[kevink]

Colorado

 

[dgoldenz]

Colorado

The Assurant and UHC plans you're looking are probably their "saver" type plans with watered-down benefits. Based on Denver zip code 80201, the Humana Monogram ($7500 deductible, $2 mil lifetime max, 100% paid up-front preventative care, full Rx coverage) for $266/month and the UHC "HSA 100" plan with $10k combined deductible for $278/month are probably the best options if you want to keep the premiums low.

 

[walkinwood]

I believe WA is also a guaranteed-issue state, not sure about OR. ...

WA, OR & CO have state funded pools if private insurers reject your application.

In NJ too, it is cheaper for us to have separate policies. The premiums are exactly the same for each of our policies, but would be more than 2x if we went for a combined policy. Premiums are more convoluted than airline fares.

 

[Brat]

When we lived in Portland I was covered by Kaiser through all stages of life. They gave great care and couldn't be better for a family with kids. They offer services in Portland Metro which includes Vancouver, WA.

Their counterpart in Seattle Metro is Group Health. They are top rated.

 

[bikeknit]

In looking at insurance policies in CO, WA & OR in particular, I found that most had a $2M lifetime cap. In NJ, most policies have no lifetime cap. (In WA & OR, I couldn't find any with no lifetime cap)

Does this bother you? What is the consensus on the lifetime cap issue. Is $2M a safe amount Obviously there's always the chance that you'll go over, but what kind of disease would cause that?

I am not an expert so check on your own but it is my understanding that the Health Care Reform Bill removed lifetime caps from all new policies - and that this is one of the things that has already gone into effect..

 

[calmloki]

Am a Kaiser member in Oregon and thought it was a seamless coverage through southern Washington, Oregon, and California. Not quite so. Am down in SoCal and decided I wanted to get a hernia fixed, turned out I had to get a California member #, then be checked down here and have Cal Kaiser ask Ore Kaiser how they felt about me having the surgery down here. Ore said ok and the surgery was done - really pretty easy, but not as totally bump free as expected. About ten times easier than our dental insurance though, so it's relative. High marks for KP still.