How To Find And Compare Health Insurance Plans

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I became the primary breadwinner for my family in February 2009. My husband and I had agreed that he’d quit his job as an International Sales Rep to go to graduate school at night and be a stay-at-home dad by day. I’d continue working at a Minneapolis-based non-profit.  Three weeks after we made that transition I got notice at my full-time job that I’d be laid off. It wasn’t immediate, thank God for that, but a few months later I did lose my job and with it, my family’s health insurance.

In the months between receiving notice of the impending lay off and actually losing my job and its benefits my husband and I debated whether we could really launch an at-home business and whether I could really become a work-at-home mom. One question overshadowed much of the conversation. “How will we pay for health insurance?” I was petrified of buying our own. I really knew nothing about how to do it or what it would cost, but I was convinced that it would be thousands of dollars per month and potentially out of financial reach.

Because of my fear I actually buried my head in the sand for the first year after I was laid off. We opted for COBRA coverage through my previous employer and qualified for a federal subsidy to the premium. Eventually that COBRA coverage and federal subsidy came to an end and I had to figure out what to do next.

How to Compare Plans

I couldn’t procrastinate it any longer. I had to sit down at the computer and figure out what my health insurance options were as a self-employed, work-at-home mom. Like any Type A woman would do, I made an Excel worksheet to track all my options and crunch all the numbers related to each plan. Once I started loading information into my worksheet, my fear melted away. Knowledge really is power.

The most valuable numbers I looked at while comparing health insurance plans were the minimum and maximum out-of-pocket expense annually.

  • Minimum out-of-pocket expense. I looked back at our medical history over the last few years and decided what I’d expect us to need in terms of the number of doctor’s office visits and prescriptions in a year’s time. In addition to paying our monthly premiums I assumed that we’d have these other basic medical expenses. For some plans we would pay co-pays for office visits. Other plans had co-pays for prescriptions. Some plans required us to pay 100% of the expenses out of pocket. I considered the total amount of premiums we’d pay annually and the cost of our essential medical expenses to be our minimum out-of-pocket expense.
  • Maximum out-of-pocket expense. The maximum out-of-pocket expense is the plan’s annual deductible amount. In most cases there is an individual deductible that applies to each individual family member, plus an out-of-pocket maximum per family. I listed both of these numbers in my Excel worksheet.

With those two annual numbers clearly identified for each different policy we were considering, I could easily compare plans side-by-side. My husband and I decided on a plan that fit our monthly budget and was a comfortable amount of financial risk for us annually, should we ever have to max out the plan.

Finding Plans

The first place I looked for plans was an online health insurance rate quote site. I normally don’t like those sorts of online quote sites, but I found them to be surprisingly useful in getting me started. I reviewed every plan suggested by the websites I visited, then took my research a step further.

I jotted down the names of the insurance companies that offer plans in my state (there were only 3 or 4). I went to each of those companies websites directly to look for any other insurance plans for individuals. I discovered a few plans that seemed like good fits for my family, but had not been mentioned in the quote sites I’d visited.

Before making a final decision, I called the customer service line for the two companies whose plans we were seriously considering. I inquired about dental insurance (which is difficult to buy apart from a health insurance policy) and confirmed my understanding of how each plan worked.

We ultimately decided on a hybrid plan – a high deductible, but no health savings account because it offers standard co-pays for office visits, prescriptions, two urgent care and one emergency room visit annually. Beyond those things, we are responsible to pay 100% of everything else up to our deductible. My biggest surprise – our premium, as a self-employed family, is only slightly more than what we were paying in subsidized COBRA premiums.

How have you navigated the waters of finding and securing health and dental insurance for your family? What advice and what questions do you have?

About the Author - Carrie Rocha

Carrie Rocha has been a WAHM since January 2010. She and her Brazilian husband, Marco, have two young girls. In June 2006 the Rocha’s decided to get out of $50,000+ in debt. Two and a half years later they’d reached their goal. Compelled to help others based on what they’d learned, Carrie founded PocketYourDollars.com. When she’s not online she’s eating chocolate, being a media correspondent on consumer issues, public speaker, or busy writing her soon-to-be-published book Pocket Your Dollars: 6 Attitude Changes That Will Help You Pay Down Debt, Avoid Financial Stress, and Keep More of What You Make (Bethany House, 2013).

 

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{ 4 comments… read them below or add one }

Loretta Oliver May 1, 2012 at 1:24 pm

We were worried that my husband would be laid off last year so I did some pricing and shopping around, but didn’t buy a plan yet. There is a lot of confusing stuff out there, so I really like the idea of using an Excel sheet to organize all the stuff you find along the way.

Reply

Kay May 1, 2012 at 4:59 pm

We were in a similar situation last year. I have been a stay-at-home mom and my husband had been laid-off so we were using COBRA until the subsidy was no longer in effect. Since COBRA was $1400/month, we decided that was something we could no longer afford with my husband still looking for work, so we looked for private coverage. We had coverage through BCBS of MN through a prior employer, so since we were familiar with them, and the plan’s coverage and cost were reasonable, we applied through them. We thought there would be no problem receiving coverage since we are both healthy individuals with no serious or chronic illnesses. We were shocked when they offered my husband and child coverage but flatly DENIED me ANY coverage. We were further shocked to find out their reason– “preexisting conditions of miscarriage and infertility” ! I would have understood if they had offered me a plan where they wouldn’t cover pregnancy costs (they do have those plans) but they flat out refused ANY coverage for me, DESPITE the fact that I am just now beyond normal child bearing years, the condition I have makes it HIGHLY unlikely (nearly statistically impossible) I could become pregnant or give birth again even IF I were younger, I am NOT seeking fertility treatments nor were they covered in the plan I selected, and my condition in NO way affects my general heath. I researched online to find out how they can do this and discovered that it is LEGAL to deny coverage for any number of life events that many WOMEN encounter. Insurance companies can deny private health insurance due to previous birth complications, previous pregnancy complications, previous C-section, infertility, miscarriage, and even for cases of domestic abuse victim or sexual abuse victim. Once denied by one private insurance company, ALL will deny you. I discovered I could apply for special coverage offered to those who have been denied insurance, but only AFTER I had gone WITHOUT insurance for 6 months.
I am writing this because although it might seem like a good idea to apply for private insurance, especially if you are younger, healthy and have no chronic health issues, however MOST people aren’t aware of the extent that insurance companies discriminate against women’s health and wellness and I would hate for them to apply without realizing the ramifications of what might seem like a minor or one time problem and how it can haunt them when trying to get private health care insurance. coverage.

Reply

Carrie Rocha May 1, 2012 at 5:36 pm

Kay – Wow, I’m sorry to hear that you have been denied coverage. I can only imagine how scary that has been. I’m really glad that you shared your story here.

My husband has ADD and so our family was denied mental health coverage – which includes counseling, which is something I’d done off and on over the years. It is certainly not as important as the overall medical coverage that you were denied, but is something I forgot to mention in my article. Our options included putting Marco on his own plan without the mental health coverage and re-applying just me and my kids for a family plan that covered us entirely, but the risk of having two separate out-of-pocket maximums was more than we were willing to do.

Would you be able to get coverage if your family became eligible for a group plan again through an employer or no?

Reply

Kay @ COBRA August 20, 2012 at 7:22 pm

The one thing I would add to be on the lookout when selecting an insurance plan is coinsurance. My last policy had 30% coinsurance without a maximum. I ended up needing surgery and owed over $25,000 in medical costs due to the coinsurance.

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