Thinking of switching to private insurance

[dex_millie]

I know some think $6000 a year for insurance is cheap but I think it is crazy. i was wondering if to switch to a private insurance and if anybody have good experience w/ them. I am thinking of doing BCBS indeminty or PPO plan they range from $150-$290 a month w/ a deductible of 2500-10,000 and has no co-insurance, and has maternity included.

The only visits we do to the doc. is well baby check-ups. I go to a NP sometimes but those I have to pay out of pocket as insurance doesn't cover them.

TIA

[AllieFaye]

Our private insurance is much cheaper than what was offered at dh's office. It would have been double our mortgage payment to stay with them. If you can get maternity included, I'd jump on it. It's not even offered in our state.

[samandhenrysmom]

Where are you finding these great deals? We are paying $530/mo through my job right now and I am about to quit and go into private practice and will cobra our insurance. I think it is going to be almost $1500/month - GASP!!!!!!!!

[wifeandmom]

Originally Posted by dex_millie

I am thinking of doing BCBS indeminty or PPO plan they range from $150-$290 a month w/ a deductible of 2500-10,000 and has no co-insurance, and has maternity included.

Seriously, where are you finding rates that low, especially that include maternity coverage?

Are those rates just for one person? I can see a policy for one person, maybe even an adult and a child, for about those prices with a $5-10K deductible.

Last I checked, private insurance for our family (2 adults, four children) is going to run somewhere in the neighborhood of $500-700/month for a policy with a $10-20K deductible, no co-insurance, and no maternity benefits. I am fairly certain that there is only ONE company that will even underwrite a maternity rider in Texas (where we live) for private policies, and the restrictions are so absurd that it truly would be nearly impossible to come out ahead (the premiums are so high, they won't cover anything for 12 months, then they cap what they'll pay at something like $5K). The only thing it would be good for is the write off that you get just for having insurance to begin with.

[dex_millie]

I go to https://www.ehealthinsurance.com. It is different depending on where you live and the prices they quote of course may be lower when you actually talk to them.

Right now I am looking at a plan for $264 for 4, one deductible for the whole family of $7000, no coinsurance, Wellness/Preventive Care(I think 4 visit a year w/ a 35copay). We don't have Physicians (Illness & Injury) included (have to figure this out more) and this one doesn't have maternity. If we did a 10,000 it would go down around 227. If we wanted to add dental it would be 72 for Value and 117 for Premium. We will be saving about 210-250 a month. There are different plans that he mentioned that was around 380 and included more w/ a 1500 deductible. Oh this will be w/ United Healthcare.

I am still new to all of this, it is starting to feel like alot to shop around and then change since I am just comfortable w/ always having company insurance but this one offered by DH company is the most expensive we have had.

[blazer]

I moved my Partner and 2 kiddos to a private Aetnea private HSA account that was on ehealthinsurance. It is $228 per month. It paid at 100% after a 5000/10000 family deductible, has RX coverage, no maternity, but did have well visit coverage. That would save us over $400 a month, which we will put in an HSA savings account to keep saving money there.
Worst case out of pocket would be $5000 per year, so I can take that risk

Just a note to you to check if they have RX coverage too some of the plans did and some did not.

[Ironica]

Keep in mind that group insurance (such as with an employer) has certain regulations on it that private insurance does not. If you are diagnosed with a serious illness, or suffer a serious injury, your rates may be raised dramatically or your coverage may be dropped altogether by private insurers. You can still have "pre-existing conditions" excluded from private insurers, too.

If you feel really sure that you'll get what you're paying for, then that sounds like a great deal, but me personally? I've got contingency plans up the wazoo to stay on group coverage no matter what happens. I would never shell out for private insurance. I'd rather put the money in a bank account and pay out-of-pocket.

Originally Posted by dex_millie

Right now I am looking at a plan for $264 for 4, one deductible for the whole family of $7000,

Ok, so you're trading a $6000 a year plan for a plan that ranges from $3,168 to $10,168 a year. There may also be stuff that will have a co-pay even after you meet the deductible (such as prescription drugs). It's a bit of a gamble.

I am still new to all of this, it is starting to feel like alot to shop around and then change since I am just comfortable w/ always having company insurance but this one offered by DH company is the most expensive we have had.

Insurance is expensive everywhere. :-/ If you find a good deal... chances are there's a reason (such as paying over $10k in a single year before coverage really kicks in).

[jen in co]

Originally Posted by Ironica

Keep in mind that group insurance (such as with an employer) has certain regulations on it that private insurance does not. If you are diagnosed with a serious illness, or suffer a serious injury, your rates may be raised dramatically or your coverage may be dropped altogether by private insurers. You can still have "pre-existing conditions" excluded from private insurers, too.

This is key...also group plans (if you qualify for one in the future) can require medical exams, questionnaires, etc. if you're coming from a private plan. It's largely the reason we stayed on COBRA for a year before my husband was able to buy group coverage for his new company

[aircantu1]

What kind of coverage/ deductible does the $6000 a year employer plan have?

Will the employer give you any sort of reward for buying your own insurance? Sometimes they'll offer a little something since they aren't having to pay for your insurance.

It doesn't seem wise to me to switch from paying $6000 a year to potentially paying $10,168 a year but my final opinion would depend on your answer to the above questions.

[wifeandmom]

Originally Posted by aircantu1

It doesn't seem wise to me to switch from paying $6000 a year to potentially paying $10,168 a year but my final opinion would depend on your answer to the above questions.

She's paying $6K a year for the premiums through her DH's work. That's not including any deductible, co-pays, or co-insurance. The $6K is guaranteed money out of pocket.

If she goes with a plan that is $2400 a year, she's automatically got an extra $3600 just in premium savings alone. Honestly, it is wise to at least consider the possibility of switching to a cheaper per month plan, put the difference in an HSA til the balance is high enough to cover a worst-case-scenerio year, and go from there.

And I'm not too sure about the statements made so far about group coverage requiring exams and such if you're coming from a private policy. My understanding is that ALL policies have to give you credit for prior coverage if they have a pre-existing clause. So, if your new job's insurance has a 12 month pre-existing clause, you'd have to show that you had continuous coverage for the past 12 months to be exempt from that clause. I've never heard or read that it mattered if you had private or group coverage, just that you HAD coverage. Off to read up on that issue...

[dex_millie]

Originally Posted by aircantu1

What kind of coverage/ deductible does the $6000 a year employer plan have?

Will the employer give you any sort of reward for buying your own insurance? Sometimes they'll offer a little something since they aren't having to pay for your insurance.

It doesn't seem wise to me to switch from paying $6000 a year to potentially paying $10,168 a year but my final opinion would depend on your answer to the above questions.

I get everyone is doing worst case scenerio, but if we do it for one we have to do it for the other. With my current plan I can end up paying the same amount. W/ my current plan it is a guaranteed $6000 a year w/ a 1500 deductible (so $7500) and a possible 20% coinsurance(depending on where the treatment is done and how serious the illness or emergency, if it is more than 12500 we will be paying alot more out of pocket because of the coinsurance)

I was talking to DH yesterday and was saying I had insurance most of my life and rarely use it, I can see switching and then something happen (God forbid). We might just go ahead and keep our insurance for now. The only thing I didn't like about the private insurance is the no coverage of sick visits(which we have never done).