[US] Wisdom about Choosing Medical Insurance as an Individual

Brian "Panda" Choi

Hey PC,

I have a friend who's looking into getting medical insurance for himself, and he feels a bit intimated by the number of esoteric terms and variety of plans that he can choose from.  I myself have the same concerns as he does.

He's single, basically a freelancer.  Lives in California.

Does anyone have specific recommendations or advice about which plan he should seek out, or factors he should consider to winnow out the health insurance plans to a select few?

MagicSugar

Uhhh....isn't Obamacare still in effect.  I've seen online anecdotes by U.S. based freelancers (they're graphic novel artists) saying that it has helped them get affordable insurance.

I don't know what's the formal term but there should be a national website that'll inform you and your particular situation (like, which state you are and which insurers are available for your budget).

Probably best to get something in effect soon in case Trump wins the prez elections and start undoing Obama social policies.

Deforges

MagicSugar said:

Uhhh....isn't Obamacare still in effect.  I've seen online anecdotes by U.S. based freelancers (they're graphic novel artists) saying that it has helped them get affordable insurance.

I don't know what's the formal term but there should be a national website that'll inform you and your particular situation (like, which state you are and which insurers are available for your budget).

Probably best to get something in effect soon in case Trump wins the prez elections and start undoing Obama social policies.

Not to get political by any means but obamacare is a freaking joke. When I tried to freelance my insurance (forced to buy by the way or else get fined) was a few hundred bucks a month for BASIC coverage. My perception before I had to buy insurance outside of an employer was that Obamacare would provide myself with an affordable option in case of an emergency. I'm a young healthy man who goes to the doctor once a year if even that. But all it really does is force you to buy overpriced insurance that will charge you fees for using it. It's crazy.

Anyways, it'd be worth it to get a parttime job that provides insurance if possible or just try to get medicaid or if he already has insurance under an employer, he is entitled to continue coverage under COBRA. If he is young enough he can try to get on his parents' insurance.

AtticusMars

Brian "Panda" Choi said:

Hey PC,

I have a friend who's looking into getting medical insurance for himself, and he feels a bit intimated by the number of esoteric terms and variety of plans that he can choose from.  I myself have the same concerns as he does.

He's single, basically a freelancer.  Lives in California.

Does anyone have specific recommendations or advice about which plan he should seek out, or factors he should consider to winnow out the health insurance plans to a select few?

Go to the California ACA website, I believe it's called Covered California, and pick out a plan there.

Assuming he's young and relatively healthy I would just pick the cheapest plan from a provider with a good network. HMO plans are typically cheaper but (as far as I know) your primary care physician directs all of your treatment. I would go that route since (again, afaik) studies on patient outcomes generally find no difference between HMO and PPOs.

If they qualify for insurance subsidies they should definitely try to get them

Deforges said:

Not to get political by any means but obamacare is a freaking joke. When I tried to freelance my insurance (forced to buy by the way or else get fined) was a few hundred bucks a month for BASIC coverage. My perception before I had to buy insurance outside of an employer was that Obamacare would provide myself with an affordable option in case of an emergency. I'm a young healthy man who goes to the doctor once a year if even that. But all it really does is force you to buy overpriced insurance that will charge you fees for using it. It's crazy.

Anyways, it'd be worth it to get a parttime job that provides insurance if possible or just try to get medicaid or if he already has insurance under an employer, he is entitled to continue coverage under COBRA. If he is young enough he can try to get on his parents' insurance.

Premiums depend on your state and your income level, ultimately though the ACA was intended to provide everyone with minimum coverage and it is accomplishing that. Premiums used to be very cheap, thanks to the fact that insurance companies would use things like preexisting conditions to avoid paying out benefits to people. Premiums are higher now because insurance companies actually have to pay for shit and incurring higher costs means customers pay more.

Unfortunately the ACA has no real means of cost control for care. Clinton wants to allow the government to negotiate drug prices which will help, Sanders is trying to push for a public option which would ensure that the insurance marketplace is competitive. Hopefully at least one of those will happen...

Kevin Albers

Selecting insurance while freelancing/self-employeed is much more straightforward now. As mentioned, just go to the ACA Markeplace web site for the state and look at 'Bronze' options (as opposed to Silver and Gold plans).

Important note: There is an 'open enrollment period' of (I think) early November to early February. That is the ONLY!!!! time a person can enroll, because Economics (i.e. otherwise, people would just wait until they found out they had cancer, and would get insurance the next day). Missing this time period can be a Very Bad Thing...you would have to wait until the next period to get insurance at an OK cost, and hope nothing bad happens to you before then...

AtticusMars

Kevin Albers said:

Missing this time period can be a Very Bad Thing...you would have to wait until the next period to get insurance at an OK cost, and hope nothing bad happens to you before then...

You can get temporary ("short-term") health insurance, but it doesn't provide minimum coverage that the ACA compliant plans provide and it doesn't cover pre-existing conditions.

Justin Meisse

Deforges how does your experience compare to private insurance rates before the ACA?

Deforges

Justin Meisse said:

Deforges how does your experience compare to private insurance rates before the ACA?

The same except I wouldn't get fined for not having insurance if I was in-between jobs.

Justin Meisse

Deforges said:

Justin Meisse said:

Deforges how does your experience compare to private insurance rates before the ACA?

The same except I wouldn't get fined for not having insurance if I was in-between jobs.

The prices were the same?  I've only known people who have compared it to workplace insurance or compared to not having any at all.  Any time I've had the option of COBRA it was ridiculously expensive, like the cost of a platinum plan on the marketplace.