Health Insurance

[inquisitive]

Hi all, would appreciate any advice on my situation.

Have been thinking about health insurance over the next year and came across some larger questions. Some background info:

I am under 30 and have been working an excessive # of hrs the past few years. Live in MA. I've decided to work part-time next year. Right now I have a great HMO plan, I pay about $21/week and everything is included including inpatient hospitalizations at the 1 covered in the plan and I pay no copays in the network. If I go to 20 hrs/week next yr my insurance will increase to $75/week.

My question: I would make more working per diem instead of 20 yrs/week part-time but would not be eligible for the health insurance plan. Since my health plan seems pretty good I'm thinking just for this reason I shouldn't do the per diem although the salary would be higher for the same # of hrs and it would allow me to work at different places which would be more interesting, instead of part-time with 1 company.

The other thing I am thinking about is that within the next few years I am hoping to transition out of my current line of work and into self-employed business and other projects full-time. What should I be thinking about in terms of health insurance at that point? I like the fact that right now everything is covered in my plan. Can I continue to get something like my current plan long-term without paying a fortune as I would be without a real employer for some time.

Thx for any info!

 

[easysurfer]

Belonging to a HMO, a lot is covered (as long as you stay with services through the HMO). However, $21/week at your age really isn't that cheap, especially since you are under 30.

Moreso, since you are thinking about transitioning out of your line of work and into self-employment in the future, have you thought about getting your own insurance?

Something like a high deductible with HSA? That won't cover as many medical expenses as the HMO, but is a portable if you decide to change your employment and at your young age, and assuming you are healthy, you should get good rates.

 

[plex]

As mentioned, your insurance is actually pretty expensive for a healthy 20-29 year old, especially if you are male. It is a different story if you have pre-existing conditions however. Assuming you are a healthy person in their 20s, young adult plans are in the $40-60/month range. The one I use has a $1k deductible, $5M limit, national+international coverage, and covers all non-preventative care (and I can go anywhere).

It gets more expensive in your 30s to self insure, it will probably be around $90-110/month at 30 and goes up from there, but that is under the old system, by the time you hit your 30s, the health reform act will change how the policies price healthy young people.

 

[Martha]

The OP is in Massachusetts where the rules and often pricing is different from much of the rest of the US. I would check with an insurance agent to see what is available to you and at what kind of cost.

 

[inquisitive]

I didn't realize that my insurance might be expensive. Considering that it will go to $80/week working part-time is really expensive, then, especially considering I am healthy.

If I do get my own insurance separate from my insurer, do I have to worry about being dropped from this new insurance if I develop a condition? Can I opt back into my employer's plan for the next year regardless of medical issues at that time?

How do I find an agent to quote me prices and info on different plans?

Thx for the info everyone, this forum has been very helpful.

 

[KM]

I'm not sure I agree with the statement that your current insurance is "expensive". It depends on where you live and the nature of your plan. You are currently paying about $84/month. What is your deductible? You can't compare a plan with a $250 deductible in one state with a plan with a $1000 deductible in a different state. It goes without saying the $250 deductible plan will likely be more expensive. That doesn't mean your plan "is expensive"....it means it is different.

In NH, an Anthem Plan with a $1000 deductible (for a 28 year old male in excellent health) will be about $218/month. I don't know what MA would cost, you have to check with insurers in that state.

Once you go to part-time, you are now looking at about $300/month. That is likely because your employer is contributing less towards your overall premium, so you might be able to do better elsewhere.

But before you decide, be sure you understand your total out of pocket expenses. Premium is just one piece of that. How often do you go to the doctors? What about prescription coverage? Do you participate in any sports that will put you in the Emergency Room on a yearly basis? I suspect your plan covers a lot.....but if you don't use it or feel you need it, you might be willing to go with a plan with a high deductible and lower premium. Just be sure you understand the differerence in coverage. A lowr premium often means less coverage -which works fine for many people. But you should be sure you compare dedubtible, copays, out of pocket, annual maximum, prescription coverages, etc. You might not care now, but you will if you get sick or in an accident.

Healthy people can often do okay finding their own insurance. But rarely can someone do better insuring themselves as a single, as opposed to being covered by group insurance through their employer. Possible, but not common.

Of course, none of this means you shouldn't go out on your own....I am only suggesting you spend some time familiarizing yourself with the different levels of coverage before you decided which plan to buy.

Good Luck!!

 

[zinger1457]

Since your in good health I agree with the other comment that you should look and see if a high deductible HSA plan is available in MA. Your contributions to the HSA savings account are tax deductible and many employers will also contribute a portion to it to make up for their reduced premium. Any money left in the HSA account when you turn 65 can be withdrawn for non-medical expenses, like an IRA. I sure wish it was available when I was younger, if it was I would have a good chunk of change saved in my HSA account by now. Unlike most other medical insurance, HSA plans have a built in incentive to maintain a healthy life style.

 

[inquisitive]

Great advice everyone, thank you. Have been reading about HSA which seems like a great idea for me because I don't use much health care so I would probably save a lot of money using a high deductible low premium plan. The main thing is that in the result that something comes up and I utilize major resources I would want the plan to cover everything over the deductible but I will look into specific plans. Whatever extra money I contribute looks like it ends up as a retirement account. And I can see all my physicians before my current plan runs out and will calculate how much it will cost for me to continue seeing them.

Someone mentioned looking into agents to compare the various plans. How are these people compensated? I will look on NAHU or AHIA to find an agent.

Dental insurance is about $10/week, does this seem reasonable?

 

[ziggy29]

Dental insurance is about $10/week, does this seem reasonable?

The general consensus is that dental insurance is rarely a good deal for those who have to pay the full price for it. That is, only employer-subsidized dental insurance is generally a good deal.

$10 a week comes to $520 a year. If you expect that the insurance would save you more than $520 a year out of pocket, then it might make sense. But since dental insurance is usually capped at a $1000-1500 annual maximum, some folks choose to self-insure. And if you think about it, dental insurance is the opposite of a true insurance model in many ways. In a traditional insurance model the insured is covered against very large losses while assuming the ability to "self-insure" smaller amounts with a deductible. In dental insurance it's the opposite -- small amounts (amounts many can "self insure" for) are covered, but very large expenses over the coverage limit are the responsibility of the insured.

 

[zinger1457]

Someone mentioned looking into agents to compare the various plans. How are these people compensated? I will look on NAHU or AHIA to find an agent.

One good place to compare different insurance policies and get quotes is Health Insurance - Find Affordable Health Care Coverage and Buy Medical Insurance Plans Online

Being originally from MA I was curious what medical insurance would cost me if I was still living there. From the link above I entered my personal info with my old MA zip code and the cheapest HSA plan available was $564/mo. Changing the zip code to where I currently live in AZ shows HSA plans starting at $184/mo. I didn't do a side by side comparison to see what the differences in the plans were other then the obvious, in MA there were only two HSA plan choices and the deductibles were low. In AZ I have 17 HSA plan choices with higher deductibles and much lower premiums.