Where to find cheap (affordable) health insurance?

[scarab007]

I'm trying to find health insurance for my girlfriend. The details: She recently moved in with me in NYC, graduated from college about 6 months ago, is currently looking for a professional job (ie unemployed atm) and is 23 yrs old.

I've done a few internet quotes but have not been impressed at all. The average quote was in the $320.s or higher a month. Since we are both young and she doesn't have a job that is a little steep for our budget.

She is in good shape, non-smoker, etc. However, her immune system is pretty weak so she is prone to the flu and occasional ear ache. Normally she just deals with it / rides it out, but that sucks and it would be good to be checkout every now and then.

Anyone have knowledge or advice on where to look?

Obviously we both GREATLY appreciate any info!

[ChiTownAbs, Inc]

I would probably recommend that you buy a very high deductible insurance. Health insurance afterall is for things you can't afford. What you can't afford is if she were to get seriously injured with a $30,000 hospital bill.

I would look into a health plan that has a deductible in the $5,000 range. Yes, $5,000 is a lot of money for somebody coming right out of college, but it isn't THAT much money.

Otherwise, if you get a $500-$1000 deductible plan, you're going to get raped.

Hard.

Twice.

[D.Pham00]

i second that. get an insurance policy with high deductible, possibly one with no office visit coverage, assuming she doesn't see the doctor that much.

[gowensby]

We've gone through http://www.ehealthinsurance.com (http://www.ehealthinsurance.com) for my wife's insurance. It gives you some different plans and options. It's worth a look.

[scarab007]

Appreciate the replies. I'll give the website a go. As far as the DR. visits, I was hoping to get that on the list so the minor things can be looked at / solutions found. She has the flu (or symptoms) fairly often, so I wanted to make sure she had access just incase it's anything that needs to be dealt with down the road. Kinda like a car, if you ignore the little things - they'll come up in a hell of a way later.

[DAC]

Has she tried Medicaid? (http://www.health.state.ny.us/health_care/medicaid/) There's nothing to be ashamed of for applying. She may just qualify

[alanstar@erols.com]

Check with your local Chamber of Commerce. I joined and was able to get their group rate for Blue Cross Blue Shield; saved me about $170/month ($310 instead of $480). You only have to stay with the COC one year, and you can still stick with the group plan.

[J-Dubya]

get married and she can get on yours

[scarab007]

get married and she can get on yours

Heh what happened to the good ole days of wed-lock?

Unfortunately my health insurance consists of oatmeal for breakfast. I've always been pretty healthy and lucky, thus I'm waiting until grad school ends and the employer deems me worthy enough for longevity. It's her immune system and proneness to illness that I'm more concerned about.

The COC thing is a great idea. I love the creativity of this site!

[lvs999]

Move to Canada to get free health insurance! -wink-

[ChiTownAbs, Inc]

Appreciate the replies. I'll give the website a go. As far as the DR. visits, I was hoping to get that on the list so the minor things can be looked at / solutions found. She has the flu (or symptoms) fairly often, so I wanted to make sure she had access just incase it's anything that needs to be dealt with down the road. Kinda like a car, if you ignore the little things - they'll come up in a hell of a way later.

Think about it this way. Suppose you pay $300 a month for 12 months. That is $3600 right out of your pocket. With that type of insurance, I imagine there would be a $50-100 deductible, maybe more.

Now, if a doctor charges $175 for the sniffles and to get a script, that would mean your girlfriend would have to visit the doctor somewhere around <b>20</b> times before you broke even between the two cases. You could easily purchase the higher deductible insurance plan, pay for the office visits and still come out ahead.

Also, I've never done this, but I've read about people talking their doctors into lower office visit fees because it's coming out of their pockets. Basically you can give the doctor a sob story about how you have a high deductible insurance plan and you'd appreciate it if they could lower the fee. Imagine if you could get $75/visit from the doctor. You'd save a LOT more than you were even expecting.

What would suck royal nuts is if your girlfriend were to get sick and the total bill comes out to $4999. That would be all out of pocket and there is nothing you could do. That is the risk you take when you buy insurance, but insurance afterall is for things you really *can't* afford.

[i86time]

What would suck royal nuts is if your girlfriend were to get sick and the total bill comes out to $4999. That would be all out of pocket and there is nothing you could do. That is the risk you take when you buy insurance, but insurance afterall is for things you really *can't* afford.

Keep in mind that even with a $5000 deductible, you pay that $5K plus the premiums. Meeting your deductible only entitles you to pay the co-payment amount. If your total bills are $5025, you still pay the first $5K in full plus (your co-payment percentage)* 25.

If there is some set amount you cannot afford period, look into the maximum out of pocket expenses for whatever plan you're interested in and choose accordingly. Definitely do the math.

[dave-o]

Check with your local Chamber of Commerce. I joined and was able to get their group rate for Blue Cross Blue Shield; saved me about $170/month ($310 instead of $480). You only have to stay with the COC one year, and you can still stick with the group plan.


This is an interesting idea. Do you know if the Group plan you got covered pre-existing conditions after a certain amount of time (i.e 30, 60, or 90 days)? I will have to check this out.

[alanstar@erols.com]

This is an interesting idea. Do you know if the Group plan you got covered pre-existing conditions after a certain amount of time (i.e 30, 60, or 90 days)? I will have to check this out.

Don't know offhand about pre-existing conditions. And every state probably has different laws about it, so whatever is true in MA may not be true wherever you are anyways....

[dave-o]

Don't know offhand about pre-existing conditions. And every state probably has different laws about it, so whatever is true in MA may not be true wherever you are anyways....

Cool, thanks for the info though. I called my chamber of commerce and they are sending me a packet on their insurance (also through BCBS). I would have never thought of going through them...

[Picot12]

Check out the local community college. They offer really cheap health insurance. She can see student health for her colds. Usually she only needs a class or two to qualify. I have a friend who is self employed and takes PE classes every semester just for the insurance.

[MrBob]

I'm in a similar boat as your Girlfriend, and I am direct enrolled in a plan with blue cross and blue shield, call Afford a Blue. While not the greatest it is pretty damn good for the 90$ a month I pay. I get five vists to the doctor a year with a 20$ cycle, I pay the first 100$ for perscriptions then they pay the rest. I'm not sure exactly, but I think I pay a 1000 and they pay the rest for hospitals. That 90 aslo covers dental, which only covers 2 cleanings completely. Anything else you are fucked.

Like I say it's not the greatest but pretty good, and It is a month to month plan that you can drop on a dime, also since it is BCBS, you can pretty much go to who you want.

Hopefully this link will work:

http://www.bcbsks.com/product_choices/individual_family/affordablue.htm?mnu=in3&

The big thing though is that I live in Kansas, so I'm not sure what they have in NY, but definetly worth taking a Look at IMO.

[scarab007]

Wow, thanks guys! Community college is a great idea, especially since they are almost everywhere and anyone can enroll. The rates for BC are perfect, I'm going to go check them out now - hopefully NY doesn't kill this option.

[LurkerDan]

Has she tried Medicaid? (http://www.health.state.ny.us/health_care/medicaid/) There's nothing to be ashamed of for applying. She may just qualify
single able bodied person in their 20's? Not in any medicaid program I administered...

Edit: she should actually try to do things to boost her immune system, in any case.

[ChiTownAbs, Inc]

"Only college you can go to with a GED is a community college- you know why that is? They be lettin all kinds of people in- crack head,prostututes,drug dealers-COME ON IN!!!"

[scarab007]

Lol Chitown.

LurkerDan, regarding "Edit: she should actually try to do things to boost her immune system, in any case."
If the world were that simple we wouldn't need wheelchairs. People could actually try to walk instead.

[JiM T]

My wife was recently dropped from Medicaid after giving birth, but our new son will remain covered until he's 18. But now I'm in the market to get her covered. Some great suggestions here, but most of the inexpensive plans don't account for maternity-related expenses. Does anyone know of any inexpensive plans that deal with this? I've been with United Healthcare/Golden Rule for a few years, and it doesn't suck, but adding a woman of child-bearing age to my plan may not be affordable. That said, I'm fine with changing my plan to something crappier to accomodate her. Thanks...

[M2theAX]

The only advice I can put out there, is if you do not have insurance and do go to the doctors, let the doctor know, chances are that they will give you "samples" of the medication that you may need and will charge you their cheapiest rate for the office visit.

[Jay G.]

I've recently found myself in the same situation as scarab007; recently moved to NYC, looking for employment. My wife has a job, but won't become eligible for the company's health insurance for 3 months. Did you find a reasonable plan Scarab?

[X]

I've recently found myself in the same situation as scarab007; recently moved to NYC, looking for employment. My wife has a job, but won't become eligible for the company's health insurance for 3 months. Did you find a reasonable plan Scarab?Are you worried something's going to happen to you within 3 months?

[Duran]

Are you worried something's going to happen to you within 3 months?

Is it worth the risk of financial ruin?

[Jay G.]

Are you worried something's going to happen to you within 3 months?
Well, yeah. Accidents happen, as can sudden health problems. I have a cousin who in June suddenly came down with a rare case of cancer. He's been hospitalized since then, and I can't imagine what the health care costs have been for him so far.

I'm really looking for a low-premium, high-deductible plan to cover any unexpected medical expenses. I don't need precription drug coverage or preventive care covered at this point. However, finding health insurance in NYC is a pain. Ehealthinsurace only offers on plan, a PPO. I've found other HMOs and PPOs, but nothing like what I want.

I actually looked at Allstate's website today, I get my renter's insurance through them. While they don't have regular health insurance, the have what they call "Supplemental Health Insurance," where they offer separate policies for Accidents, Disability, and Cancer:
http://www.allstate.com/Products/AllstateProducts.aspx

These would cover about 90% of what I'm concerned with, especially accidents and cancer. However, it wouldn't cover any other health problems that may come up.

[Officer Cartman]

I have my own business, so I was in the same boat.. Went with ehealthinsurance.com as well. What I haven't found is good dental insurance, anyone have any suggestions for that?

[drmoze]

New York State has very inexpensive healthcare options for self-employed and low-income people. Do a NY websearch for health care programs and you'll find it. You can get a decent choice of hmo options with a low deductible for around $200/month. Well worth it!

[Jay G.]

You can get a decent choice of hmo options with a low deductible for around $200/month. Well worth it!
Is that $200 for single or two person coverage? I'm looking to cover both myself and my wife. So far, the cheapest HMO I've found is around $500 a month for that.

[joesa]

Scarab,

I recently graduated from Penn State and get Health Insurance through the Alumni program for $450/6 months. It's a $1000 deductable plan. See if anything like that exists for your girlfriend. Although, it doesn't cover routine medical things.

[atari2600]

i have blue cross, but i dont konw what the hell is up with my "plan". i wanted the cheapest plan they have and the person on the phone recommended one for me. i have a $40 co pay per office visit plus 40% of all fees.

well i goto the office for an annual checkup, pay my $40 and everything is fine. a few weeks later i get a bill for $200. im like wtf...so i call blue cross and the lady gives me this bull shit:

"the plan only covers if something is wrong with you...its not just for checkups or physicals..."

so i ask "ok what if i said something was wrong with me?"

"then it would have covered you"

"ok so next time ill lie and say something is wrong with me first"

she laughed, realized how right i was and didnt know how to answer. i still dont get it. my so called "plan" wont cover me unless something is wrong yet i have a $40 office copay? but next time if i say i dont feel well, then it covers me? am i wrong or is this just strange?

[Jay G.]

joesa, thanks for the tip about Alumni plans. My wife just graduated, so I'll see what she can get with that.

my so called "plan" wont cover me unless something is wrong yet i have a $40 office copay? but next time if i say i dont feel well, then it covers me? am i wrong or is this just strange?
Sounds like your plan doesn't cover preventive care: annual checkups and the like. I know it seems strange at first, but if you consider that probably the majority of health-care costs for the average individual is preventive care, you can see why they were able to offer such a low premium for a plan that doesn't cover it.

You can, of course, lie about whether or not you're ill to get coverage for your next checkup. You should be aware, however, that technically you'd be performing an act of fraud.

[atari2600]

joesa, thanks for the tip about Alumni plans. My wife just graduated, so I'll see what she can get with that.


Sounds like your plan doesn't cover preventive care: annual checkups and the like. I know it seems strange at first, but if you consider that probably the majority of health-care costs for the average individual is preventive care, you can see why they were able to offer such a low premium for a plan that doesn't cover it.

You can, of course, lie about whether or not you're ill to get coverage for your next checkup. You should be aware, however, that technically you'd be performing an act of fraud.

im sure thats what it is but what im confused about is if i simply say "i dont feel well" then all of a sudden they cover me? it could be fraud but what defines "feeling well"? if i have a headache? my stomache hurts? you can always find something that doesnt feel right.

[Jay G.]

im sure thats what it is but what im confused about is if i simply say "i dont feel well" then all of a sudden they cover me?
Because if you don't feel well, then something's possibly medically wrong with you, and it's not preventive care. I know it doesn't make sense to you, but that's the way it works.

I really can't speak from experience, but if you go in with a headache, I'd assume the doctor isn't going to give you a full physical and run the same tests he would for an annual checkup. So, for a headache, you'd be paying $40 plus a portion of the fees for a doc to look at you, ask a few questions, and prescribe you some aspirin.

[mhaneoka]

Because if you don't feel well, then something's possibly medically wrong with you, and it's not preventive care. I know it doesn't make sense to you, but that's the way it works.

I really can't speak from experience, but if you go in with a headache, I'd assume the doctor isn't going to give you a full physical and run the same tests he would for an annual checkup. So, for a headache, you'd be paying $40 plus a portion of the fees for a doc to look at you, ask a few questions, and prescribe you some aspirin.


In the world of insurance and medical billing, there's a distinction made between routine/preventative care (you're not having any symptoms -- the "checkup", pap tests for women, colonoscopy, etc.) vs problem-based visits (you've got symptoms). My understanding is that an office visit can be billed as all routine care, all problem-based, or a combination of both. So, if you go in for a check-up but also ask about non-routine problems at the same visit, the visit may be considered partly routine and partly problem-based; in this case, your insurance might pay for only the problem-related part, and you'd still foot the bill for the part of the visit that was routine.

Putting the fraud question aside, just saying you have some random symptoms won't necessarily fool the insurance. The visit itself and all tests (blood tests, x-rays, scans, etc.) have to have some kind of associated diagnosis, some reason behind the visit or the tests; e.g. a cholesterol check might have a "diagnosis" of "screening for cholesterol problems". The insurance is going to have questions if they see "headache" as the reason for getting a cholesterol test. (And that's assuming you can get the doc to bill things that way -- effectively to lie on your behalf -- since the doc can get into trouble if s/he's caught knowingly billing things inaccurately, even if it's out of sympathy for the patient's situation.)

At the risk of stating the obvious, you get what you pay for. Yes, some insurances are definitely better than others. However, if you're paying significantly less for one plan compared to what's average for your area, then there's generally missing compared to other plans; maybe there's a high deductible, maybe there's zero prescription coverage, maybe they don't cover certain tests...or maybe they don't cover routine care.

Sorry about the length. Hope this clarifies things.