Advice for getting Private Health Insurance for the first time?

Hey all,

I've been without health insurance since I was 18, almost 8 years now.  I've been REALLY wanting to get health insurance for YEARS now, but I've worked (and still am) as a contractor and have not been eligible for company insurance.  I've looked at the private health insurance plans many a time over the last several years, telling myself I really need it, but I ultimately get turned off by the confusing policies, and also the fact that almost all health insurance plans are simply not fair.  All plans are different on so many levels, and I get very overwhelmed by trying to figure out which is a right plan for me.  Not only just different price deductibles, but it's amazing to me how plans can differ on what they cover or not.  There seems to be so many exceptions to coverage, that in most cases, I often ask what the hell is the point of it if my insurance is going to make me pay premiums then say all the service I need is not covered?  The worst is that most plans say they won't even begin to cover for a diagnosed disease till you have paid for at least 12 months.... Frustrating.

Since I've made more income this year, I've been catching up on yearly doctor visits, but I definitely feel I DO NOT get the treatment I deserve since almost all doctors will never want to test anything that may be costly (which is everything).  As I get older, I want to make sure I am in tip top shape, not just have different doctors tell me "It's probably nothing".  Plus, it will be good to have insurance in case of any accident or medical emergency. 

Does anyone have any tips or suggestions when looking for a health insurance plan that won't make me feel ripped off and also cover most medical needs and tests?  I've only been looking online so far. 

Thanks!

Welcome to the world of Obamacare.

The best advice that I can give you, is to look locally for a company that provides health insurance. You will get the chance to sit down with a person, face to face and ask questions. Also, going forward, you do have to get a health insurance plan that meets the government requirements. No idea what they are, but a good agent should be able to help you. There are other things too, such as look for a plan that may come with a discount to a local gym, or something like that.

Private health insurance is ing expensive, but on the other hand, if you get in a situation where you get pretty sick or are in an accident it pays off.

My understanding of the 12 month deal is that if you lapse in insurance or never had it they stick you with that ( I guess to make sure you don't use it and run?). A friend of mine is looking at health insurance and has to take something like 5 or 6 packages to get what he wants covered. 

Real life DLC.

I read somewhere that insurance has to cover 60% of every hospital visit you have or something ridiculous. I pray that's not true because it sounds expensive as hell. 

I don't have health insurance, my current priority is dental insurance which almost seems like a bigger pain in the ass than health insurance. 

The 12 month thing is for preexisting conditions. They won't pay to treat something you already know you have. This kinda makes sense as getting insurance after a diagnosis would be a huge money-loser for them.

I'm a big believer in insurance and covering risk, but if you've gone this long I would check out www.healthcare.gov to see when the Aca plans will be available in your state. They should be a bit more standardized and easy to understand.

I would watch out on dental insurance. I haven't seen many plans that are worth the money. Many good dentists aren't even taking insurance anymore.

I asked my dentist about insurance and between what he told me and what I am finding so far the only good dental is available through business. Obviously though it's gonna take one hell a company to dish out what I'm looking for company wide. My teeth are pretty jacked and I wish I had the option to drop a big part of my paychecks to work towards fixing it. Guess I might have to just save up a cash fund. 

I had luck negotiating a little with the dentist. I got 10% knocked off my bill by paying cash.

Dental insurance sucks, it's expensive and it's got a cap at $1000 or so depending on your carrier and coverage. Then some of them make you have it for a year before they do anything for you.

When I was unemployed I just took out a catastrophe plan.  I was young (26) and in pretty good shape with no pre-existing conditions.  So my plan was just like a $30/month fee and the deductible was around $8000.  So obviously I wasn't going to the hostpital or doctor unless something extremely serious happened to me.  But if I were to be in a car wreck and need major surgery, that $8000 would have looked a lot better than $50,000+ if I wasn't insured.

I carried that for about a year until I found a new job with health insurance benefits.

Thanks for all the comments!

Reading all this though makes me feel like I was right to keep staying away from getting health insurance for the last 8 years.  My research agrees with the statement that unless you can get coverage through a company, you're going to get ripped off AND not covered to the amount you would like.  (without paying an arm and a leg of course). 

It was nice the last few years that I've been making more income that I've just been making the regular doctor visits (eye, dentist, GP, etc) and paying cash, but there has definitely been many times I felt I haven't gotten conclusive diagnosis or testing because the doctors figured I couldn't afford it.  I even just had some blood work done and it was like $250 for 2 minutes and a couple vials of blood.  I've had some stomach issues as of late that my doctor keeps insisting is stress.  I fear it could be something more sinister.  (Though I tend to be a terrible hypochondriac)  As I get a little older, I'm not settling for just "well, it's probably nothing, you seem fine", when really the doctor means to say "Well since I'm not going to run these $2000 tests on you, it looks fine from just my physical examination".  I want to assure I'm healthy.

Maybe it would be wise to just get a catastrophe plan for now, but that still doesn't solve my wishes to ultimately get the tests and care I need if the doctors think it should be done. 

It doesn't but you absolutely need a catastrophe plan at the very least.

Same boat as you bro. Contractor, will probably be for life. Here's what I ended up finding;

If you're young and relatively healthy, HSA plans are the way to go. You put in up to $3250 a year in a separate HSA bank savings account, which does not expire at the end of the year and is pre-tax money.

So a quick comparison of my plan (140/mo, 1500 deductible) to a traditional plan;

- Some people like "no deductible" (or low) plans. $380/mo or $2880 a year more for a $100 deductible plan. That means if I'm avoiding critical care in less than a year's time you have more in your HSA savings than you paid in extra insurance. So if I go to the hospital in 2 years, I'll have spent $5760 more for the $100 deductible plan, my HSA deductible is $1500.

- Or let's compare this to another traditional plan I see, with a $1500 deductible (same as mine) at $200 a month. Mine is $50 less, and I don't get the option of having a HSA savings account.

Now, this all changes if you're one of those people who just can't stay out of the hospital, need expensive monthly meds or have a pre existing condition. Then HSA plans don't really seem to make sense. Like I said, I'm young and am lucky to have relatively good health.

Just don't forget, one of the purposes behind HSA plans is to be saving money into a HSA account, so when the day happens that you do need to pay that deductible it's covered. Since the money you put away is pre-tax dollars, it's worth more money than is put in. Or you can use it to pay for other health related stuff, like dental work.

For preventive care, you should be able to negotiate lower cost visits based on being upfront with them, "how much discount can you give me if I just pay you in full at the time of service." Offices like people who pay on the spot. They don't have to deal with the wait time and frustration of billing/insurance. My dentist, for example, charges me about 30% less than listed prices. If the office you talk to doesn't want to give you a discount call another, someone will. (and then, you can pay with your HSA card, since it's as good as cash for medical visits, making the trip even cheaper)

Health insurance is the pinnacle of bullshit. My car gets better insurance than I do. Annual deductibles, finding out after the fact what insurance will or won't cover, the prices? It's a scam from top to bottom. Now that people will be forced to get insurance, the scam is sponsored by the government, which is even more incredible.

First though, doctors aren't turning you away or not running tests because you don't have insurance. Most doctors don't even know if you have insurance. The front desk/billing deals with that. So if the quality of care isn't good, then welcome to 2013's healthcare landscape. It's not going to be any better with insurance. In fact, the largest medical facility in my city is no longer taking Medicare/caid patients, because the government payouts are so late, so bad, and the bureaucracy isn't worth it.

I have insurance through work, but they don't cover my family, so we spend over $440/mo for my wife and three kids. Then any time something other than a general checkup comes up, we're out of pocket hundreds of dollars. Since medical procedures are ridiculously over-priced to begin with, even 80% of a minor procedure (or God forbid, child birth) is astronomical.

I also didn't have insurance for several years, and currently don't have dental, and to me, unless you have small children, if you're in your 20's, early 30's, save your money, wait until you have to get health insurance by government mandate (surely insurance companies will lower premiums since they are being force-fed new customers by the government...right? /sarcasm) Catastrophic insurance is an option, but with the car crash example, oftentimes depending on fault, you'll be covered by the other guy's insurance.

To me, the health industry, and insurance, is the country's greatest legal scam...and now the government is involved. This will clearly end well.

The solution to your problem is Direct Primary Care.

http://www.dpcare.org/dpc  (this explains the system but their website sucks for referrals)

This is the model my wife uses for her practice.

basically you pay a monthly fee, With that you get a yearly exam. Each visit is a low price (My wife's is $10, some charge more). Because they don't bill everything through insurance, you get a reduced rate for tests.  Some test that she used to have to charge $100 to insurance, she can now charge the actual cost of $8. (And no she wasn't being greedy before. insurance companies set these prices) . Some practices also have networks of specialists who have a lower "cash price" for things.

This could be used with an HSA and you should get some catastrophic plan. And yes, this qualifies under Obamacare.

If you are interested, let me know where you are and I can probably get you a name to check out.

Some states actually have programs to help you find the insurance program you need, but some states will say you and leave you out to the cold b/c socialism.  I dread the day I have to find health insurance in another state.

Uhhh. Wouldn't "socialism" help him get health insurance? Where are you going with this?

Some states have already planned to cut health care programs for many of their poor not because of budgetary problems (which while a concern, isn't that too big a problem as the Obamacare law did make the Federal government handle most of the money) but for political ideology, ie sticking it to the President.  Some of these health care programs, if not all, usually provide services to help you find private health insurance, if you don't qualify forpublic (if there is any.)

More specifically, how certain programs are targeted by political officials for approval.

Like how pro-life candidates will rally about trying to shut down planned parenthood because of abortions, because it gets them the votes; when in reality planned parenthood isn't just an abortion clinic (but they will never mention that part.)