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Ask HN: US-based freelancers - how much is health insurance?

10 points by eliot_sykes ↗ HN
I'm from the UK, my wife is from the US, and we're in the early stages of considering a move to the US, and I was just wondering what the typical range is for health insurance costs for a healthy ~30 year old male freelance programmer. I'm just looking for a ball park. $500-1000 per month?

21 comments

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mgkimsal
If you have enough savings, you can go with a 'high deductible' plan, in which you cover the first $x thousand dollars out of pocket, then split some costs with insurer, then insurer covers you after $y dollars spent.

The price is highly dependent on what state you live in. In North Carolina, I have a high deductible plan with a $5500 deductible for $270/month, which covers my wife and I, both older than you, and we're not in perfect health.

A side benefit is that if you use a high-deductible plan, you're allowed to put money in a 'health savings account' which is tax deductible, and you can use that money to pay for pretty much any medical expenses you have. It rolls over year to year, and can be treated like any other retirement account (investments, etc).

If you go with more traditional 'i don't ever want to pay anything out of pocket' coverage, you'll likely be looking in the $500-$1000/month range, again, depending on what state you're living in.

For a single person in Michigan, for example, it might only be around $200 - http://www.bcbsm.com/myblue/plan_individualcareblue.shtml but similar coverage with a 'high deductible' might only be $60/month - http://www.bcbsm.com/myblue/plan_flexibleblue.shtml

sman
I did not realize HSA could be rolled over. I am an employee and my place of employment offers an HSA thru AFLAC, but I remember the AFLAC rep stressing that it was a use it or lost it deal.
mgkimsal
That's not an HSA then - that's a 'cafeteria plan' thing I bet. HSA is your own account via an HSA-capable banking institution. It's basically just another IRA, but you can pay for medical expenses from it with no penalties.

The 'cafeteria plans', IMO, are a bit of a joke, specifically because of the 'use it or lose it' clause, which forces people to waste money or buy stuff they don't need.

I did have one HR person tell me once that they'd cut you a check back for the diff if it wasn't spent, but then it counts as 'taxable income' and this was said with some degree of gravity, as if that was some type of 'ultimate sin' - having taxable income! I'd rather keep the 70% of my money rather than spending it on something vaguely 'medical' that I do not need, thank you.

krs
The rep may have been talking about flexible spending accounts. FSAs are fine if you can predict how much you'll be spending on health care, but if you overestimate you will lose what you don't spend.

One big advantage of HSAs is that if you lose your job the HSA money is still there to draw on if you need it.

stonemetal
to add to mgkimsal's answer if you plan on having children and want that be covered be sure to ask about it. You may need extra coverage for such things.
hop
I pay about $100/month with a $2500 deductible. Doctor visits are a $10 copay. I'm 27.
starkfist
I paid $270/m for the "best" plan I could get at Kaiser Permanente in SF. (~30, male, no significant health issues.)
csmeder
Doesn't SF have a free health plan that covers anything the city hospital can do. (well not free but you pay with extra tax on retail products). Does this drive down the price of the KP plan?
starkfist
The SF city plan is for individuals who make less than $55K.

I could have paid less for my insurance but I was making a lot of money and hadn't seen a doctor in a decade, so I wanted to make sure any horrible condition I had developed had the best care options available.

csmeder
Do the news articles about Health insurers using the question "do you have any past health issues" and only looking into your past if something expensive comes up.

I read about this woman who had something minor, such as ear infections as a child you, and forgot to put it on the intake form. So years later when she got cancer the Insurer dugg into her past and found the minor issue that she forgot to put on the intake form.

This was such a big deal a Senator grilled the insurance company about it but they responded with "we are just doing what we our stock holders hold us to" or something like that.

I wish I could find the article that talked about this.

lsc
yup, it's a big deal, and a big reason to get on a group plan rather than getting individual coverage. Keep in mind, though, group plans usually cost more (because they accept unhealthy as well as healthy people, while the individual plans only accept healthy people.)
icey
Google for a broker in the area you're moving to and call them. They should be able to generate a quote for you over the phone and give you a more concrete idea of insurance rates for your demographic in that area.

Rates are dependent on many factors, age, tobacco usage and location (sometimes down to your county or zip code for some carriers).

You may be able to find a quote service online as well, depending on the location you're moving to; that way you don't have to talk to anybody.

noisebleed
If you happen to end up in New York, check out Freelancers Union: http://freelancersunion.com/

I'm paying around $300/month for a decent basic PPO and dental (for just myself)

csmeder
anything like this in california?
rada
You can take a look at actual prices on freelancersunion.com.

Keep in mind that the next couple years are anyone's guess because of all the new healthcare regulations coming in. (A lot of insurance companies are hiking up their prices ahead of 2014 when they will be forced to offer more coverage at lower premiums).

It also really varies by state so you should mention where you are moving to.

exline
Where in the US will you be living? Based on the current comments, it makes a pretty big difference. I have a plan for my family (me, my wife + 2 kids) and have a very high deductible ($7500) and still pay $500 a month. I live in California. I've seen my rates increase from less than $300 a month to the current $500 a month in the last 2 years. I was one of those hit with Anthems/Blue Cross 40% rate increase this year.
eliot_sykes
If we move, in or near a big city is about as clear as I can be at this stage.
jph
I pay $200/month for health insurance from State Farm in San Francisco.

I use a high deductible plan because it saves me money, as I'm healthy and prefer to pay cash for low cost items.

lsc
First, I'm about your age, and I'm living in California, so that's where these numbers come from.

If you are /really/ healthy, I mean, no medication, nothing but good checkups in the last three years, you can get really good insurance for well under $500 a month. A high deductible plan where you pay the first three grand a year of expenses might be a better deal at $150-$160, though.

https://www.kaiserpermanente.org/ is pretty good and has online quotes; that's where I got these quotes.

Now, if you have had anything wrong with you in the last three years, you simply can't buy health insurance without a job, as far as I can tell, for any amount of money. This is the situation I'm currently in, and I'm going to end up getting a job for a few months. The thing is, if you have a job with health insurance, you can continue that health insurance for 18 months after you leave the job (and another 18 months for a total of 3 years, if you are in California.) you just have to pay the premiums. Uh, last time I did that my premiums were $518/month for some /really nice/ insurance that covered everything.

My CORBA just ran out a few months ago. (note, you have to do some legwork to get CAL-Cobra.. you have 60 or 90 days from when your first 18 months is up to do so.)

what's wrong with me? a history of ADD and a (successfully treated) detached retina a few years back... not exactly cancer.

Oh, if you really are perfectly healthy, private insurance is often cheaper than CORBA continuation of group coverage. The problem is that if anything really expensive happens to you, a team of professionals will go over your original insurance application with a fine-toothed comb in an attempt to get you disqualified. Group insurance, on the other hand, you get no matter how sick you were going in, and they can't disqualify you because you made a mistake on your application. (which is why it costs more)

My own personal plan is to get a regular job with health insurance once every three years. At least until 2014 when the new health insurance regulations go into production.

eliot_sykes
Thank you all for your responses. Some of it feels like I'm trying to understand a foreign language, but I've got enough information to start making some calculations.

Thanks again HN.