Thing No. 1 Nothing beats having a job.
Health insurance
costs are one of few good reasons to work for “the man.” If you
are part of a working couple then you have to figure out who has the
better spouse policy and consider having that person cover the
other. Same goes for who’s got the kids covered.
Thing No. 2 The dreaded PPO/HMO/POS debate.
HMO is the
cheapest. The coverage is usually just fine. The hassle is,
you’ve got to run everything through a Primary Care Provider – he’s
your gatekeeper so you need to find one that you can stand to talk to
and when you do have to see a specialist, he/she has to be “in
network.” It works out just fine for lots of people and the
exciting thing is that the employee contributions are low and the
paperwork is almost non-existent. You go to the doctor, you pay
your little co-pay and you’re done. Same thing with
prescriptions. (Although, they usually insist that you fill ongoing
prescriptions by phone or mail so get your doctor to write you a
3-month script whenever the seasons change.) Expect co-payments
to be anywhere from $10-$25 for comprehensive (but not overloaded)
coverage.
If you’re a hardcore elitist and you MUST have your “doctor to the
stars” then a PPO will let you go completely out of network but they
will only pay a portion of the cost (40-50%) and it’s likely you’ll
have to pay a deductible (average is $250-$500) Or, it will let you
make a co-pay for one of the network’s Preferred Providers if you can
bring yourself to see someone whom they consider “preferred” but has
never treated Cher. Premiums and employee contributions will be
higher for PPO and some things may not be covered at all.
Finally, a POS is supposed to be a hybrid of HMO and PPO. It’s
actually much closer to a PPO but the general concept is that it is
supposed to be a slightly lower cost than PPO but you still have a
Primary Care Physician. The twist is he/she can give you
“permission” to see someone outside the network. This out-of-network
visit will still cost you more than an HMO co-pay but, theoretically,
not as much a full-on PPO. This is all a big pain in the A.S.S if
you ask us, but we know more than a few hypochondriacs with their
special needs so, we’ll leave it to you to know who you are.
Thing No. 3 Another acronym: HSA.
This is a Health
Savings Account. It allows you to deposit pre-tax dollars into a
savings account that can be withdrawn anytime for qualified health
benefits. These are good for health costs that you know you’re
going to incur…like a new eyeglass prescription or some dental surgery
that you’ve been putting off too long. If you put enough each
year into this account to cover these known costs, then, by virtue of
them being pre-tax dollars, you’re getting a break on the
cost. If you have to make $1,000 gross to net $600 after
taxes, this way the full $1,000 goes to your medical bill instead of
paying it with the $600 that you ended up with in your pocket and
having to earn more to cover the full bill. Now, don’t go
crazy. We don’t want you locking up lots of money in this thing
because you can only use it for medical costs. That’s why it’s
good for medical costs that are already predestined for the year.
Thing No. 4 Find out these things (if you care).
Coverage for:
Preexisting conditions on-going prescriptions, mental health, how long
is the list of in-network providers? (Any chance your doctor is on it?)
If there is an approved (in-network) hospital anywhere near you.
Preventative care coverage (physicals etc.) Coverage for alternative
medicine (e.g. acupuncture, holistic etc.)
Thing No. 5 You entrepreneurs, stick to your ways.
• Jack up those deductibles ($1,000)
• Pay annually.
• Check quotes online. www.quotesmith.com
• Watch the lifetime caps – anything less than $500,000 is too low.
• Try to find a policy that doesn’t exclude
pre-existing conditions. If you can’t, then don’t sign on for
more than a six-month waiting period.
• Look for a small-business group plan in your
industry Communicating for Agriculture and the Self-Employed, Inc., is
a non-profit organization offering group insurance for self-employed
people selfemployedcountry.org.
• Check the insurance company’s rating www.ambest.com.
• Look into a short-term policy if you just want to
get through a 6 to12-month period
http://www.healthinsurance.org/shorttermhealthins.lasso
• Deduct medical costs from your taxes (laws vary on
how much is deductible but add it up and stick it in the line
item. If you hire your spouse and pay him/her a salary, you
can deduct 100% of your medical costs from your federal taxes.