Buying Family Health Insurance

When we moved to Arizona I was faced with a really low salary from the mister, along with GIANT insurance costs for our family.  We had really been sheltered from insurance costs when we lived in CA.  Yes, we had a little out of our check but it certainly wasn’t the 1k/month that I was looking at to cover myself and the kids.

We made the decision to go with an individual plan.  Myself and the kids are all healthy {knock on wood} and at the time I was at a great weight and my only “pre-existing condition” was kidney stones when I was pregnant with Ms P (that was back in the day when pre-existing conditions mattered).  Because I only want to see doctors when I am being paid for it I really limit our doctor exposure.  I even keep strep tests on hand at home so I don’t have to pay for a full visit just to find out we don’t have strep.

I think it’s just SO hard to compare insurance plans.  I will say that a few of the things in Obama care has made it a little easier.  Here are a few tips for when buying family health insurance.  I know a lot of people are being forced into the marketplace (which could be a great thing, you might actually save money — we sure did) and are uber confused. 🙂

Oh, I also have a post all about if birth classes are covered by insurance that might be interesting for you.

It is going to be expensive

Unless your income is low enough to go onto the state-funded insurance your cost is going to be a lot.  That’s all there is to it.  Even with a high deductible that rarely pays it is going to cost a lot.  We can’t fool ourselves that ObamaCare has made insurance cheaper by asking everyone to buy in.  #screwed  Just to give you an idea, all 5 of us are on an individual plan right now with a 5k deductible and it costs us just under 800/month.  Our mortgage is juts over 200 dollars more than our health insurance. {silent tear}

What is a deductible?

I think most people have started to figure out a deductible — but in case you haven’t…  A deductible is an amount that you have to pay before they kick in their part.  Some plans waive the deductible for basic doctor’s office visits.  Some don’t (mine doesn’t).  There are a few things that ObamaCare requires that they waive the deductible.  So far I’ve found that physicals, well-checks and birth control have all been “free” on our plan.  BUT, if you go in for a physical/well-check and you mention ANY complaints you will end-up paying for the entire visit.  Basically, if you go in and aren’t healthy you’ll end-up paying.  Mention to your doctor that you are ONLY there for a well check and to let you know if the visit is starting to veer outside of that.  My doctor asked me if I had allergies, and I said that I had seasonal allergies but that I take an over the counter prescription for it and do just fine.  400 dollar bill to my house because of that.  I did talk to the doctor and said that was totally unreasonable and we settled it. {sigh}

What do you have?

Do you have medical conditions that you’re seen for often?  You’re going to want to figure that into your cost.  Of course, not all things can be predicted, but if you’re often into the doctor you’re not going to want a super high deductible.  You’re not going to save enough doing that to make it worth it, most likely.  If you have records, see how often you’ve been to the doctor in the last year.  Think that most basic visits are at least 100 dollars.  More complex visits, and don’t forget prescriptions, sky-rocket from there!

What are you trying to cover?

Are you at a financial point to cover everything besides catastrophic stuff on your own?  If so, get a high deductible.  If your finances are so tight that something that’s a thousand dollars will completely ruin you, you would want to consider a plan with copays.  You need to look at it just like you do car insurance.  I have a larger deductible there because I am willing to absorb the extra cost if we have an incident.

Look into an HSA

I don’t know everything about an HSA but we have one.  I put money in it monthly and it can be used for anything healthcare related.  That’s mainly doctor’s visits, prescriptions, dental (aka, braces!) contacts and glasses at our house.  You have to be on an HSA compatible plan (most of them have very high deductibles and they do not waive copays for office visits).  The money will be there until we spend it all.  I can even withdraw it like retirement.  I don’t have a ton in there right now, but you can get into plans that allow you to invest it like a retirement account.  It is TAX SHELTERED.  That means you’re not taxed on the money you put in there.  There are limits, so check with your CPA or a reputable website.  I think, at some point, everyone will be on this type of plan.  It really is the most cost-effective.  It really makes me think about things before we seek medical attention.

**This year I ended up switching to a Health Care Ministry.  And yes, I did feel as weird about it, as it sounds.  But it was the right decision for our family — you can read more about it at that link (it’s where I share our decision)**

Use a brokerage.

When we moved here I just happened to find an AMAZING health insurance broker — you can find them at www.abpbrokers.com.  Seriously, not being paid a penny by them but they have been SO helpful.  I can’t recommend them more highly!  I asked Melissa from their office if she had any good advice and she had a ton which I’m just going to paste here with her permission.  Good stuff!

Reasons why you’d want to use a broker….

1. We are licensed professionals who go through hours of compliance training and recertifications each year to make sure we are up to date on the latest policies. — I have asked them TONS of questions, it has been MUCH easier than doing it on my own! -H
2. It is NO COST to use a broker! The rate for a plan is the same with one as without a broker, but with a broker you get a professional to help you with service issues throughout the year and with questions/guidance at renewal time.
3. Independent brokers and agents usually contract with multiple companies and plans, so you don’t only get a salesperson who is direct with that one carrier and can’t compare mulitple options for you!

And then her 3 tips for choosing an insurance plan:

1. BE REALISTIC when choosing a plan and premium. You are the one who will need to make the premium payment each month, so if you choose a plan that’s great on paper, but not realistic within your budget then your policy will lapse for non-payment. Then you could be locked out for the rest of the year until the next open enrollment, when if you had started with a plan that was within your budget you’d at least have some coverage in case of emergency.  — OOoo, I hadn’t even thought of that, GREAT advice! -H
2. Focus in on what points actually matter in a plan. Are you someone who goes to the doctor every month or sees a lot of specialists? Then you’ll want to make sure you have copays avaialable up front, and not a limited number of them, or only available after you’ve paid the entire deductible. If you rarely use the insurance, try and find one that maybe offers tax benefits (like high deductible plans with Health Savings Account options (my personal favorite)). Then you’ll again have coverage in case of emergency, but in the meantime month to month you’ll have a lower premium overall, and maybe get tax savings benefits too!
3. Confirm with your doctors what plans they contract with. I can’t tell you how often members choose a plan based on a rate that looks good, but then can’t see their doctors because they didn’t check them first. Most plans being offered anymore are HMO options so networks are extremely exclusive. If your doctor doesn’t contract w/ your plan, you won’t get any coverage if you go and see them.

And just something general for people to remember…. you get what you pay for. If you are in the lowest priced plan available, you probably also are going to have the lowest benefits available. Just because each plan now is required to cover the same tests/procedures.. it doesn’t mean they cover them at the same rate. Health insurance is now being priced out to be really there for major events. Take your car insurance for example… it doesn’t cover filling up your tank, car washes, new tires, basic repair.. it’s strictly for the major claims you can’t see coming. Health insurance isn’t for the sniffles or random anti-biotics anymore… it’s for the cancer and the emergecy surgies that would otherwise bankrupt you. (All wellness and preventive is included at no cost on all qualified health plans now, and should always be taken advatage of, just remember to tell your doctor you want them billed as wellness, so there is no cost to you!)

**This just in — use Modern Medical to save on your doctor’s visits, with or withOUT insurance!  Click over to this post about how to see a doctor online, or go to Modern Medical and save 25% off your first month with cupon code CURLS**

**TIP – if you aren’t in the AZ area and want to find a broker, the best website to use is www.nahu.org – this site offers a ‘find an agent’ tool who can give you broker’s contact information for all over the country.

***BEWARE – lots of people are in plans now that are marketed as health insurance.. but are not truly ‘qualified health plans.’ They are limited benefit plans that pretend to be insurance, and come with very skilled salesmen. These are plans that offer only limited visits to a doctor each year, usually have ‘no network’ and pay you a cash amount whenever you use the plan. ALWAYS ask your broker if the plan they want to sell you is a qualified health plan, because if not then the IRS has the right under the new healthcare law to fine and every member of your family for not having the correct coverage in place.

Thanks to Melissa at ABP Brokers for the great advice.  I can’t recommend them any higher.  They have been really good to us.

Photos from Dollar Photo Club

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