qweds

Hello again,

I did do a search but was surprised not to find anything, so if this is old stuff please just redirect...

So I'm changing jobs and the place i'm going to has a slightly unusual health policy. you can opt into the office plan but that runs about $300/month, apparently because of the necessity of having maternity in all group plans. i'm a 22 unattached male and so maternity isn't of great concern at this point.

the other option is to secure independent insurance and the office will pay 25% of the cost. this seems like a pretty good deal. Initial quotes from Blue Cross and Humana look like ~$150 or so a month with dental.

Now since I'm from Canada and a recent college grad this is my first experience with American style insurance. I cannot seem to make any sense of deductibles, out of pocket, co-pay, etc. Presumably low numbers for all of these is good?

Anyone out there have any good advice? I'm in Chicago btw and will be getting a plan to start October 1.

thanks

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tim(mah)

Sage

Blue Cross is a good insurance plan- at least in my expierence.

Basically insurance works like this-

You're insured against something bad happening to you that would require you to go to a doctor. Depending on what plan you have, you might be covered against any and all reasons you want to go to a doctor, or you might have a plan that requires you to only go to a doctor when you're really sick (usually, if this is the case, you have to call your provider first and tell them what's going on, and then they tell you if it's ok for you to go to a doctor or not).

Once you get to the doctor, and get your thing checked out, you go up to the receptionist and she runs your insurance and then that's where the "deductible" and "co-pay" come into plan.

- Firstly, there's different types for different insurances, but what they're basically trying to tell you is how much money you have to pay out of pocket(meaning, out of your salary) when you go to the doctor

- A deductible is an amount of money- can be anywhere from $50 to $5000- that you have to pay out of pocket per year (and that year is set by your insurance company, not by the calendar) before your health benifits kick in. Not all plans have a deductible. It is generally good for this number to be low, although the lower the deductible the higher the monthly payment. So, let's say you have a $250 deductible on your insurance. That means that you have to pay $250 of medical visits out of pocket before your health insurance will start paying for things.

-After you meet your deductible is when the term co-pay starts to make sense. A co-pay is just like it sounds- it's how much you pay when your insurance pays the rest. For example, on my insurance, I have a 20% co-pay on all medical visits- this means that when I go to the doctor, I pay 20% of the cost of the visit up front, and the other 80% is filed with the insurance and they pay it. My chiropractor visits cost $57 every time I go- so I pay $11.40 (which is 20% of the total cost of the visit) and my insurance pays the rest.

Generally, yes- low numbers for all of those things is good. However, low numbers up front can mean high monthly payments- and that is when you have to ask yourself "do I really need to be paying this much for insurance?" How many times a year do you go to the doctor? If you generally don't go to the doctor, and would want insurance in case something major happened (like appendicitis), perhaps a higher deductable would be good for you- it would mean low monthly payments but you're still insured.

If you throw out more specific questions, like just what it is you're confused about, I'll try and help answer them- I'm not an expert but I know my heath insurance!

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qweds

cool,

well i called humana, just b/c that's the group policy I have now. They said that deductible only applies to hospital and contract work. office visits are just copay.

anyways, i very rarely go to the doctor. About the only thing I would use it for besides emergencies is to get lab work done for general std testing and a yearly physical.

however I do want a plan that has dental. apparently the humana plan is a 6 month waiting period for procedures and a $50 copay plus 50/50 cost sharing. doesn't sound very good to me...

Are there any good dental plans available for individuals?

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tim(mah)

Sage

Try calling up Blue Cross again- and look online, that's where Martel and I found our insurance and we think ours is pretty fair. If you don't really need the coverage for doctors visits, then look for something really simple as far as the medical coverage and perhaps spend a little more on a dental policy. Trust me, there's fifty BILLION different plans out there- it just takes a little digging to get what you really want/need!

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analog

What a bunch of horseshit. They can't fix it for their male workers?

Insurance covers so much of having a child, it's crazy. If kids cost more to have, people wouldn't just have them for the hell of it like they seem to be.

Cynthetiq

thats like asking the rest of the government to not have to pay taxes for schools since you don't plan on having kids...

we all subsidize something for someone else...

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flstf

You might want to look into a HSA (Health Savings Account). You can put money into it like an IRA (about $3,000 to $5,000 per year) and it grows with interest, also it is tax deductible. You have to carry a large deductible health insurance (I have 10,000 deductible) which is much less expensive than most insurance packages.

You can pay all your medical and dental expenses from the HSA until you reach the deductible of your insurance. If you are in good health and can handle the deductible if you get really hurt, it might be something you may want to look into. The money that is not used for medical expenses grows over the years and all reverts to you to use anyway you want once you reach 65.

I think Anthem Blue Cross and State Farm Insurance are two companies which offer HSAs.

qweds

I've heard different things about deductibles. when i called humana they said the deductible only counted when really bad shit happens, like a hospital, but that for regular office visists and whatnot that's only a copay.

if i go for an hsa can that be transferred b/w insurance companies?

are hsa's bush's big fix for medicare?

thanks for all the help...

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tim(mah)

Marvelous Marv

You're wise. Blue Cross dental sucks most of the time.

There are good dental plans, but you have to look for them in regard to what they cover, not how much they cost.

Find a person there who likes their dentist and ask that dental office what insurance is good. Also, remember that a dental plan is tailored to the employer, so the same insurance can be good or bad, depending on what the employer is willing to pay.

The same goes for medical, of course.

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"The problem with socialism is that you eventually run out of other people's money."
Margaret Thatcher

flstf

As far as I know they are transferable just like IRAs and I don't think Bush has anything to do with HSAs.

I like the idea of building up a medical account fund that grows over time and is also tax deductible. If you don't use it then it eventually becomes part of your retirement money.

I wish I had started one when I was younger, I would love to have all the money I have spent on health insurance over the years plus interest. There is a reason that most major American cities have giant skyscrapers owned by insurance companies, .