Go Back  British Expats > Living & Moving Abroad > USA
Reload this Page >

Getting health insurance outside of employment?

Getting health insurance outside of employment?

Old Feb 28th 2012, 12:28 am
  #1  
Forum Regular
Thread Starter
 
janicedean164's Avatar
 
Joined: Nov 2011
Location: Clayton, NC
Posts: 84
janicedean164 will become famous soon enoughjanicedean164 will become famous soon enough
Default Getting health insurance outside of employment?

Hey we were wondering if anyone else has come up against this. I've gotten a job which offers health insurance but the plans they offer are just rather awful. We are looking at getting individual health insurance as some companies offer better rates, less coinsurance, etc. etc. We spoke with United HealthOne and they told us that because neither of us have been living in the US for 12 consecutive months they are unable to insure us.

Anyone else come up against this or are aware of any companies that will provide insurance? We really don't want to get stuck into the state insurance which is far from being any kind of deal.

Thanks for any help!

Janice & Dean
janicedean164 is offline  
Old Feb 28th 2012, 12:55 am
  #2  
Lost in BE Cyberspace
 
Joined: May 2010
Location: San Diego, California
Posts: 9,620
SanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

Goodness, how awful can a Group plan be compared to an individual plan?

What are they proposing as premiums for you both/what restrictions if any/co-pays etc/deductibles.

Don't be taken in by low starter rates for premiums for individual plans. These will increase after 6 months and yearly afterwards. My own premium doubled in 2 years.

Also you won't know your final starter rate until you have submitted the full application form with your health history for the past 5 to 10 years. Pre-conditions can put up your premium or mean they won't give you a final offer.
Group plans rarely have pre-conditions as a restriction.

Have not heard about the 12 month rule and not offering insurance because of it.

Look on ehealthinsurance.com for some guidance as to what individual plans are offered in your area and ball park rates etc; but I would seriously look at your Group plan again, since I know of few people who would not take that as a first option.
SanDiegogirl is offline  
Old Feb 28th 2012, 1:10 am
  #3  
Forum Regular
Thread Starter
 
janicedean164's Avatar
 
Joined: Nov 2011
Location: Clayton, NC
Posts: 84
janicedean164 will become famous soon enoughjanicedean164 will become famous soon enough
Default Re: Getting health insurance outside of employment?

We also just had a call back from Cigna who have said they cannot do anything until we have lived here for 6 months so don't know if this is a new thing.

So the deals being offered are with BCBS State Employers plan:

Basic 70/30 Family Deductible of $2799/Co-Insurance Maximum of $11379/$35 Co-Pay for Primary Care/$81 for specialist/(This is some of the stuff the package comes with)-In Network

For Just Employee-Free
+ Spouse-$581.00 a Month

Standard 80/20 Family Deductible of $2100/Co-Insurance Maximum of $9630/$30 Co-Pay for Primary Care/470 for specialist(This is some of the stuff in this package)

For Just Employee-$26.00 a Month
+ Spouse-$717.00 a Month

And these may go up or down as we would have to answer a series of questions health related before a final quote is issued.

Its only myself working at the moment, my husband is still looking for work so we really need a package that covers us both.

Also the deal with United was $530.00 with a $2500 deductible & no Co-Insurance to worry about. (This was before any health questions) but was a far better deal when looking at it straight off & neither of us smoke & we rarely drink. More importantly neither of us have had any serious illness's or operations at any point.
janicedean164 is offline  
Old Feb 28th 2012, 1:29 am
  #4  
Lost in BE Cyberspace
 
Michael's Avatar
 
Joined: Jun 2008
Location: San Francisco Bay Area
Posts: 10,678
Michael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

Please read the entire thread and then if you really think you want non employer provided health insurance, then your first visit should be to a mental hospital.

http://britishexpats.com/forum/showthread.php?t=740518
Michael is offline  
Old Feb 28th 2012, 2:01 am
  #5  
Forum Regular
Thread Starter
 
janicedean164's Avatar
 
Joined: Nov 2011
Location: Clayton, NC
Posts: 84
janicedean164 will become famous soon enoughjanicedean164 will become famous soon enough
Default Re: Getting health insurance outside of employment?

Thanks for the thread. Skimmed through the threads briefly but there are so many out there. We get the point of not going for individual plans if it can be helped but even speaking with people who have worked for the district for years now, they've gone with individual policies over the state employee packages.

One had gone away from their individual policy, took the state employees package for a year and then went back to the individual package because they were able to save $250 per month on what they had been paying previously.

I guess our hang up is they want us to pay a lot for the insurance and then quite a bit more on top of that whenever we use it. I know that it's still a deep discount compared to just trying to pay straight out but it's still just no where near as competitive as it used to be.

We had been paying about 10% of wage in the UK and that covered most things. Here it is more like a third of your salary to have anything half decent & to add a basic dental & vision plan. Then there is the whole debacle of coinsurance....last time I had a group plan would have been into 2007 and there was no coinsurance. How new is that as alot of friends & family we have spoken to have never heard of it? And then you add in the fact that things like maternity is only covered if there are complications, you need to have supplemental insurance now just to have kids! It's all just ridiculous!

The one big question has to be for a field where there are a huge amount of companies how is it not competitive at all?
janicedean164 is offline  
Old Feb 28th 2012, 2:17 am
  #6  
Lost in BE Cyberspace
 
Michael's Avatar
 
Joined: Jun 2008
Location: San Francisco Bay Area
Posts: 10,678
Michael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

This is one of the political issue conservative against progressive. Conservatives claim only 1% of individual policies get canceled each year so the system works well but unfortunately the 1% are the ones that get sick and cost the insurance companies too much money. Then the person tries to get insurance and no company will cover them.

So if you want to take your chance that you will not be one of the 1% yearly that get sick, then individual plans may be perfect for you.

If you aren't going to be that 1%, then there is no sense in even having health insurance because you will pay less for your medical bills than you will be paying for premiums.
Michael is offline  
Old Feb 28th 2012, 2:23 am
  #7  
Lost in BE Cyberspace
 
Joined: May 2010
Location: San Diego, California
Posts: 9,620
SanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

Well, the way I would tackle it would be to take a look at ehealthinsurance, find out which plans are available to you, pick out say, 4 or 5 of the ones that really suit you and apply to them all at once. That way you can truthfully say that you have not been denied insurance up to that point.

At the same time I would look at the Group plan with a fine tooth comb and then, if offered something by any of the individual companies, I would do a final comparison- premiums, restrictions, deductibles etc and would also take into consideration that individual plans can increase at a much higher rate than Group plans.

Note, since you mentioned maternity, most individual plans do NOT cover maternity costs.

Good luck.
SanDiegogirl is offline  
Old Feb 28th 2012, 2:39 am
  #8  
Lost in BE Cyberspace
 
Joined: May 2010
Location: San Diego, California
Posts: 9,620
SanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond reputeSanDiegogirl has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

Originally Posted by janicedean164
We also just had a call back from Cigna who have said they cannot do anything until we have lived here for 6 months so don't know if this is a new thing.

So the deals being offered are with BCBS State Employers plan:

Basic 70/30 Family Deductible of $2799/Co-Insurance Maximum of $11379/$35 Co-Pay for Primary Care/$81 for specialist/(This is some of the stuff the package comes with)-In Network

For Just Employee-Free
+ Spouse-$581.00 a Month

Standard 80/20 Family Deductible of $2100/Co-Insurance Maximum of $9630/$30 Co-Pay for Primary Care/470 for specialist(This is some of the stuff in this package)

For Just Employee-$26.00 a Month
+ Spouse-$717.00 a Month

And these may go up or down as we would have to answer a series of questions health related before a final quote is issued.

Its only myself working at the moment, my husband is still looking for work so we really need a package that covers us both.

Also the deal with United was $530.00 with a $2500 deductible & no Co-Insurance to worry about. (This was before any health questions) but was a far better deal when looking at it straight off & neither of us smoke & we rarely drink. More importantly neither of us have had any serious illness's or operations at any point.
Just took a look at these figures and although they might look rather high even the most expensive at 743.00 per month is for two persons, so 370 per person, I don't think, sounds too 'out of the park' when compared to some individual plan costs. Also this plan has a family deductible of 2100 (presumably 1050 per person) which again is quite good. The specialist fee of 470 is very - strangely -high if this an office visit. I have never visited a specialist who has charged more than 300 bucks.

While not the best plans in the world you might be surprised how much individual plans will cost when you compare apples to apples.

You could always take up the Group plan while looking around for individual cover.
SanDiegogirl is offline  
Old Feb 28th 2012, 2:43 am
  #9  
Lost in BE Cyberspace
 
Michael's Avatar
 
Joined: Jun 2008
Location: San Francisco Bay Area
Posts: 10,678
Michael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

Unfortunately the way health insurance companies work is based on risk analysis. They expect to pay between 60% to 80% of the premiums received in benefits (each company has a different target percentage). At the end of the year, they determine if they hit their target percentage and if they didn't they make a list of all their customers that cost the company too much money and see which ones of those can be cancelled according to state law.

Then they analyze those policies and the current health of that customer looking for reasons that the policy can be cancelled according to state law. If they find a policy that the state would allow them to cancel that policy because somehow they can call it a preexisting condition and any other reason that they can find, they cancel that policy. When they finally find enough policies that they can cancel to meet their next years target, they stop searching through the remaining policies.

You live in a southern state and generally those states have very weak rules concerning cancellations. I was surprised about Brat1 having her policy canceled since generally Connecticut has better consumer protection regulations than southern states but somehow the insurance company could claim that her current illness was due to something that had occurred a long time ago and therefore was able to call that a preexisting condition even though they knew about the previous problem or researched her medical records when they issued the policy.

Last edited by Michael; Feb 28th 2012 at 2:54 am.
Michael is offline  
Old Feb 28th 2012, 3:02 am
  #10  
Lost in BE Cyberspace
 
sir_eccles's Avatar
 
Joined: Mar 2010
Location: Phoenix, AZ
Posts: 8,106
sir_eccles has a reputation beyond reputesir_eccles has a reputation beyond reputesir_eccles has a reputation beyond reputesir_eccles has a reputation beyond reputesir_eccles has a reputation beyond reputesir_eccles has a reputation beyond reputesir_eccles has a reputation beyond reputesir_eccles has a reputation beyond reputesir_eccles has a reputation beyond reputesir_eccles has a reputation beyond reputesir_eccles has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

Blue cross is generally considered to be quite good and have good network coverage. Those numbers look "normal" to me and I doubt you would best that privately.
sir_eccles is offline  
Old Feb 28th 2012, 3:10 am
  #11  
Lost in BE Cyberspace
 
Michael's Avatar
 
Joined: Jun 2008
Location: San Francisco Bay Area
Posts: 10,678
Michael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond reputeMichael has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

Originally Posted by sir_eccles
Blue cross is generally considered to be quite good and have good network coverage. Those numbers look "normal" to me and I doubt you would best that privately.
Blue Cross used to be a non profit organization but during the 1980's,the government passed laws that would reduce their profits (doesn't make sense since it was non profit). So Blue Cross sold the company in different states to different companies to make a lot of money and allowed those companies to call themselves Blue Cross of state xxx. So now there are about 40 different companies in the US calling themselves Blue Cross and only a small number of those companies are still part of the original Blue Cross non profit organization. The only thing that is common between the different Blue Cross companies is that they use a common provider list.

Comparing Blue Cross of North Carolina to Blue Cross of California is like comparing apples to oranges.
Michael is offline  
Old Feb 28th 2012, 12:48 pm
  #12  
Heading for Poppyland
 
robin1234's Avatar
 
Joined: Jul 2007
Location: North Norfolk and northern New York State
Posts: 14,455
robin1234 has a reputation beyond reputerobin1234 has a reputation beyond reputerobin1234 has a reputation beyond reputerobin1234 has a reputation beyond reputerobin1234 has a reputation beyond reputerobin1234 has a reputation beyond reputerobin1234 has a reputation beyond reputerobin1234 has a reputation beyond reputerobin1234 has a reputation beyond reputerobin1234 has a reputation beyond reputerobin1234 has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

Originally Posted by Michael
Unfortunately the way health insurance companies work is based on risk analysis. They expect to pay between 60% to 80% of the premiums received in benefits (each company has a different target percentage). At the end of the year, they determine if they hit their target percentage and if they didn't they make a list of ........
Hang on.. so if we citizens choose to move to a single-payer, government run scheme, we'll save between 20% and 40% of our national health costs?

What are we waiting for??
robin1234 is offline  
Old Feb 28th 2012, 12:53 pm
  #13  
Bob
BE Site Lead
 
Bob's Avatar
 
Joined: Aug 2004
Location: MA, USA
Posts: 92,167
Bob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

You want the group plan.

Personal plan tends to be not much use except in an emergency....anything serious and they'll drop you from cover.

Might be able to get top up insurance to cover deductible if that was your concern.
Bob is offline  
Old Feb 28th 2012, 1:01 pm
  #14  
Bob
BE Site Lead
 
Bob's Avatar
 
Joined: Aug 2004
Location: MA, USA
Posts: 92,167
Bob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond reputeBob has a reputation beyond repute
Default Re: Getting health insurance outside of employment?

Originally Posted by SanDiegogirl
Just took a look at these figures and although they might look rather high even the most expensive at 743.00 per month is for two persons, so 370 per person, I don't think, sounds too 'out of the park' when compared to some individual plan costs. Also this plan has a family deductible of 2100 (presumably 1050 per person) which again is quite good. The specialist fee of 470 is very - strangely -high if this an office visit. I have never visited a specialist who has charged more than 300 bucks.

While not the best plans in the world you might be surprised how much individual plans will cost when you compare apples to apples.

You could always take up the Group plan while looking around for individual cover.
Yeah, sounded pretty decent for a family offering. Not the best, but a lot better than a lot of others too.
Bob is offline  
Old Feb 28th 2012, 1:20 pm
  #15  
Forum Regular
Thread Starter
 
janicedean164's Avatar
 
Joined: Nov 2011
Location: Clayton, NC
Posts: 84
janicedean164 will become famous soon enoughjanicedean164 will become famous soon enough
Default Re: Getting health insurance outside of employment?

Originally Posted by Bob
You want the group plan.

Personal plan tends to be not much use except in an emergency....anything serious and they'll drop you from cover.

Might be able to get top up insurance to cover deductible if that was your concern.
But this is the problem, why in god's name should there even be a need for a top up. When you consider we are looking at over $700.00 for both myself & my wife without any details they decide can up that, once you add in both Dental & Vision we are already at nearly $1000.00 per month & that's without any top up & both co-pay(We knew about this) & then Co-Insurance(Which Janice was only last over here a couple of years ago, so this a very new addition) still to be paid when needed as well.

Let's not even talk about us wanting to start a family at some point this year.

As a salesman even I have to say how the **** in a field where there are so many different companies(Notice I did not say competitors, lol) is this such a complete & utter rip-off.

And then to top it off you may not even need most of what you are paying out for, the sooner healthcare reforms can be pushed through the better as I would love to know how individual plans can be so easy for the money grabbing leaches to cancel.

At the moment Janice is going to double check what the actual premium is as it is showing a completely different amount online to the paperwork they gave my wife because sadly with only 1 wage coming in at present I have said as she can have the same coverage for $28.00 it would cost us both over $700.00 to have for the time being I would rather only she was covered, not perfect but when you throw in deductions & paying back my wife's school loans we would barely have enough money to live on & that's without saving for our own place so we can move out of living with my father-in-law.

Well we will see I suppose but thanks so far for everyone's input.
janicedean164 is offline  

Contact Us - Archive - Advertising - Cookie Policy - Privacy Statement - Terms of Service -

Copyright © 2024 MH Sub I, LLC dba Internet Brands. All rights reserved. Use of this site indicates your consent to the Terms of Use.