Inexpensive 3rd Party Health Insurance

I have health insurance from www.ehealthinsurance.com. It's Anthem, $107, no dental. These are the quick details of it:

• Plan Type
• PPO
• Estimated Cost
• $107.00
• Office Visit for Primary Doctor
• $30 copayment, no deductible
• Office Visit for Specialist
• $40 copayment, no deductible
• Coinsurance
• 20% after deductible
• Annual Deductible
• Individual:$500
• Separate Prescription Drugs Deductible
• None
• Prescription Drugs
• Generic: Prescription card: No deductible. Tier 1 non-specialty drugs: you pay the greater of a $15 copayment or 40% coinsurance; $5,000 annual max. per person. You receive max. benefits when you choose generic drugs, when available. Tier 2 specialty drugs through PrecisionRX Specialty Solutions: 40% coinsurance up to a $500 out-of-pocket max. per script and annual $10,000 out-of-pocket max. per person.
• Brand: See Above Generic Drugs
• Non-Formulary: See Above Generic Drugs
• Annual Out-of-Pocket Limit
• Individual:$2,500
  Includes deductible
• Lifetime Maximum
• $5 Million per person
• Health Savings Account (HSA) Eligible
• No
• Out-of-Network Coverage
• Yes (Details in plan brochure below)
• Out of Country Coverage
• No

What state are you in OP?

OP,

Health insurance, especially individual health insurance varies in every state... recommendations as to coverage, price etc is all state specific.

I do Commercial Health and life insurance as my daily job. I work for an agency and we are appointed commercially in every state, we have our health and life license in only 4 states. (MI, AZ, FL, and NJ).

What I will say is given a prescription you can easily be denied individual coverage, there are no mandates (in most states) that require all the players take on medical conditions. Given that you are most likely going to be stuck writing two policies one for you on a medically underwritten carrier, and one for the wife on a guaranteed insurer, i.e. anthem, Blue Cross etc.

If you have any sort of LLC, or business it would be best to also check into getting the insurance under that name, getting a "group" plan has many advantages compared to the individual market.

Another thing you may consider is the temporary insurance available to you... they can normally run from 1 month - 6 or 12 months, and can be renewed a time or two. No underwriting but its major medical only, and most times no RX coverage.

Other factors that effect your rate on health.

Zip code
Age
Health history
Tobacco use (possibly)


Good luck.

Canadian meds: http://pharmacychecker.com

I've been trying to verify how much you can reliability trust their ratings. Two things I'm impressed by is that Google uses them. You can't advertise on Google as a pharmacy unless you've been certified by pharmacychecker. And, the guys behind that web site were involved with Congress trying to get legislation passed whereby all foreign pharmacies must pass certain checks to be able to export drugs into the US. They were saying these are the checks pharmacychecker has been instituting all along.

I can't vouch for the reliability of that site personally. I don't know enough. But, I can tell you it's not a sham. I just don't know how effective they are.

Jack up your deductibles and get meds from Canada. That's what I do. Hopefully you have enough cash that in the event something does happen, you can pull it out of savings. I went to ehealthinsurance way back when I got mine. Blue cross was the cheapest for me and they are an excellent company.

I told my doctor I was gonna get Canadian meds and he was excited. I was surprised. Canadian meds are very accepted these days by the medical community in the US,


Also, search lifehacker.com. I vaguely remember stories about being able to join groups, like groups for people who have their own small businesses and other groups. Then, you can hook onto that groups health insurance policy. You pay premiums, but they aren't as much as getting it individually.

Costco apparently offers affordable health insurance if you live in California. It requires the executive membership (with a yearly fee for that itself) and a monthly fee for the insurance, but I'm told it's decent.

[quote name='levander']Canadian meds: http://pharmacychecker.com[/quote]

I went ahead and ordered some meds from one of those sites. I'll let you all know how it goes though Costco is sounding mighty good for some cheap insurance.

Nice. I've kinda been looking for insurance myself due to the fact that my employer's plan blows.

I don't suppose there are any tips to getting AFFORDABLE insurance when every time I go to the doctor, they take one look at me and scribble all over my medical records that I have a pre-existing condition? I tried asking some support groups for my condition and most of them basically say 'you're screwed', and more than a few of them have just given up and stopped all forms of treatment.

[quote name='VioletArrows']I don't suppose there are any tips to getting AFFORDABLE insurance when every time I go to the doctor, they take one look at me and scribble all over my medical records that I have a pre-existing condition? I tried asking some support groups for my condition and most of them basically say 'you're screwed', and more than a few of them have just given up and stopped all forms of treatment.[/quote]

It really depends on your illness. The more serious, the less likely you'll get anything reasonable or anything for that matter.

It really says something about the system that the more you need health insurance and medical care, the less likely you are to get it.

It's not cancer (though that's on my record too now, thanks mom.), it's just chronic, disfiguring, resistant to treatment, and leads to everything else that no one wants to treat.

[quote name='Musichead13']I just got laid off last week and my wife's health insurance is nearly 500 a month. We don't use the doctor much at all but I'd like something that would be a cushion god forbid anything happened to any of us. My wife does have one prescription a month (100 dollars) and I would like to include a prescription plan as well. Any information is greatly appreciated.[/quote]You're eligible for COBRA benefits through your employer. Congress recently passed a bill which will subsidize 65% of the cost for 18 months. You have 60 days in order to elect coverage. If you do elect coverage, it is retroactive to the day you were laid off. All the terms are quite beneficial to the ex-employee (at a significant cost to the company).

[quote name='VioletArrows']It really says something about the system that the more you need health insurance and medical care, the less likely you are to get it.

It's not cancer (though that's on my record too now, thanks mom.), it's just chronic, disfiguring, resistant to treatment, and leads to everything else that no one wants to treat.[/quote]Most likely way you're going to get that covered is through an employer's group insurance. Large plans are a big enough risk pool that insurers are willing to take on whatever pre-existing conditions people might come in with.

Thanks for the replies. I didn't know about Cobra until my father in law mentioned it. Nice of the job to give us all the information we needed! They just sent out the Cobra information to me yesterday, hoping it arrives soon.

I've been looking for individual coverage too. Everyone i've found has cost out the ass. Damn colitis....

I've used this site for my girlfriend several times:

http://www.canadapharmacyonline.com/

It's a lot cheaper than going through her insurance.

1. She needs brand name for this drug, so the drug comes in a sealed factory container as well as an extra standard pharmacy bottle (the quantity she buys doesn't have a corresponding size from the factory, so it's 60+30 for a 90 day supply).

2. You need a valid prescription from a doctor, to be faxed to their 866 number after you order.

3. It takes like 2-3 weeks to get it since it has to go through customs, so order early. However, their customer service is prompt, and the medicine is stamped from the factory just like it would be if you bought it here. She hasn't had any problems since starting to take medicine bought here.

Good luck.

[quote name='Musichead13']Thanks for the replies. I didn't know about Cobra until my father in law mentioned it. Nice of the job to give us all the information we needed! They just sent out the Cobra information to me yesterday, hoping it arrives soon.[/quote]

I didn't know about that 65% government subsidy law. With that COBRA damn well should be the cheapest. But, I'd still shop around (e.g., just go to ehealthinsurance). When I got laid off, Blue Cross was a lot cheaper than my companies plan.

Although, I had fewer benefits, like no chiropractor coverage.

[quote name='banpeikun']Most likely way you're going to get that covered is through an employer's group insurance. Large plans are a big enough risk pool that insurers are willing to take on whatever pre-existing conditions people might come in with.[/QUOTE]

Its not that they are willing, they are forced to take all people... now the big thing is if you have went without coverage for more than 62 days then they can still rider out your preexisting condition for a set amount of time..

If you stuck doing individual look at the non medically underwritten plans... a lot of time those are the county plans, the local Blue Cross (Anthem) and maybe another option or two..

If you do not have employment, consider opening a business or LLC to get "group" health insurance through your business. It bypasses most individual loopholes of the carriers not having to insure you and allows you to potentially get in on a group plan and its set of mandates. This does not mean however it will be less expensive.

One last thing I see people stumble on all the time is coinsurance... remember just because someone says you have an 80% plan or an 80/20 plan does not mean they are all the same. After your deductible (which can be 2-4 times the single deductible amount for a family) you may have to split the cost of medical care (called coinsurance) with the health carrier... the most common split is an 80/20. Meaning the carrier pays 80% of claims, and the covered individual pays 20%.. But when does your 20% cap out, thats called the stop loss.

You can do 80/20 of 5k, meaning your 20% caps at $1000, or you can do 80/20 of say 40k, meaning its 8000. I have seen higher stop loss amounts as well. These are just examples.

There is a lot to learn about buying health insurance yourself.

[quote name='Musichead13']Thanks for the replies. I didn't know about Cobra until my father in law mentioned it. Nice of the job to give us all the information we needed! They just sent out the Cobra information to me yesterday, hoping it arrives soon.[/QUOTE]


If I remember correctly you did have 90 days to apply (60 is being mentioned so it may have been revised). They (your previous employer) also has strict rules to follow when administering cobra... I mean they have to send the letter to you certified etc. If they fail to follow those rules they will lose the court battle. Just food for thought...

COBRA is a bitch, I always tell my customers to get an administrator for it.

Its not mandatory on employers with less than 20, or 22 employees, I forget which. I am sure the info is easy enough to find online, however if they are under that size and offer it once, they have then set a precedent of offering for everyone going forward.

Apologies to OP if it seems like I am hi-jacking the thread. However I too am in a similar situation, and I need to save as much money as I can.

Unfortunately for me I have a bad case of acne (which can be painful) to the point where I need to rely on medicine such as Doxycycline (50mg), Retin-A (.04%), Differin, and Protopic to calm my acne down. Otherwise it will become very bad where each acne head will have pus.

The thing that kills me is that my private health insurance (Tonic from Blue Cross) is expensive. It costs me close to $200/month (having raised the prices again), and I still have a $40/copay. The medicine itself is expensive for example Retin-A and Protopic can easily cost me $200 if I don't ask for a rebate offer from my doctor.

Also I don't know if the doctor is just milking it, but she makes me come to visit every two months, and once appeared to be visibly upset when I said that I did not want to come so often. But I need her to get the prescriptions for my medicine.

By the way, I live in Southern California, so I was wondering if I can get any good advice on lowering the costs of my insurance and drug costs in general.

Please any advice will be appreciated, I am in a tight bind.

Thank you in advance.

/\ grab a phone book and call a few local agents. They will most likely steer you right.

Crowolf, did you check out pharmacychecker that I posted earlier in this thread?

Also, call another doctor and make an appointment their next time you need a refill. Maybe even mention to the receptionist that you're wondering if your other doctor is making you come in too often.

Actually, if you switch health insurance, sometimes the new health insurance doesn't pay for meds you're already on.

But, if you think you're having to go to the doctor too much, I'd call your health insurance company. Less doctor visits when they're not preventing anything sounds like something the insurance company would be interested in. If you don't have to go to the doctor as much, the insurance company doesn't have to pay as much. Maybe they'd have suggestions for alternatives? I know Blue Cross gives advice in mailers and stuff like that on how to save medical costs.

Thanks for the advice, levander, I'll see what more I can do to mitigate these costs, and yes I checked out pharmacychecker seems like a great alternative. I'm going to try that out.

I was talking to a friend and found a pretty good tip. I don't know about all states, but in Georgia, Blue Cross offers cheaper rates for short term (e.g., unemployment situations) health insurance. At the top of bcbsga.com there's a link for "Plan and Apply Online". Just make sure in the wizard that link sends you through to put you need insurance for under six months. And then when they ask how long, probably say six months.

Definitely something to look into.

bluecross.com probably to find the web site for your state.

[quote name='JolietJake']I've been looking for individual coverage too. Everyone i've found has cost out the ass. Damn colitis....[/quote]
Haha I'm in exactly the same situation. I'm paying a crap load for the insurance I have now for it.