Health Insurance Advice Needed

[SALvation]

I could use some advice on health insurance. My wife currently works for a hospital and gets great coverage and insurance for both us 2 and our newborn son for practically nothing. Anything we need is pretty much free minus a small copay. Well since she just gave birth a month ago, she plans on leaving her job there in a couple of weeks and going to a part-time contract position in the hospital. The upside is its part time and the same pay but the downside is there is no insurance available (no other direct positions available due to a hiring freeze).

I can get insurance from my company for us 3 with no problem, but its a pretty crappy policy and I would be paying about $550/month for us. That's a huge swing in rates for us coupled with the fact that she is going from full to part time and our coverage would be worse than what we have now.

My question is, what are the other options out there? Does anyone use a different company or agent? Is health insurance over the net reliable? Any advice would be greatly appreciated.

 

[geckojohn]

I'm a Blue cross agent in san diego... feel free to PM me if you have any questions.

 

[ReiAyanami]

i'm a blue cross member and it only costs $30~ a month student rate

 

[msparish]

You ought to see how much Cobra would cost you. You'd get to keep the same insurance you have now, but you would have to pay for it. I don't know if the length of time varies from state to state, but here if my wife were to quit her job we could keep the insurance for up to 36 months. See how expensive that would be as a start.

 

[se7en]

I work in a hospital too and deal /w insurance all day long.. .. ..

Yes there are tons of health ins. options BUt what you can afford and how much it will pay is going to greatly differ. With no group plan (ex. getting it thru work) you are going to pay more but how much more depends on the company you go with.

BCBS is one of the better carriers along with United healthcare they offer some very good plans with High co-insurance, low deductibles (if any), and low out of pocket amounts. There are smaller companies avaible but most small companies actually use a larger company policy and just stick their name on the card so you could get "Ma and Pa's health Insurance" and somewhere on the back of the card you would see "Send all claims to BCBS...po box yadda yadda" which means the plan is thur BCBS.

here is some tips on choosing a plan:

Co-Insurance - For office visits should be 100% (means you pay copay they cover everything else), and for testing done outside the visit look for 80-100% (some doctors bill bloodwork,xrays as a hospital service which would not be covered as a "physician visit") so you would want good coverage here as well.

Copay - usual is 15-25 of PCP and 20-50 for a specialist every clinic will collect this at time of care and SOME may not even see you without this.

Out of Pocket- Simple enough means the total you can spend on your family as allowed by your plan before they pick up the tab some companies include copays, and deductables..some do not.

Calendar year deductable - The amount just like a car you must pay each year before they start covering that 80-100% co-insurance for testing.

ER/Urgent Care/Admission copays - Pretty easy to understand you pay "x" amount each time to go to each place.

Plan types:

PPO - Go anywhere you like as long as they take that insurance no PCP needed or referals.Will have out of network benefits in case you have to go to a MD say out of state that isn't contracted with them.
EPO- Provided by employer same as PPO
HMO - Managed care, will be cheaper but rightfully so. Cannot go wherever you like must go to their doctors and use a PCP from their list to obtain referals for specialists. Some HMO's specify "Open Access" which is better as it gives you more freedom to go where you like.Most HMO's have NO out of network benefits means you go to an MD not contracted with them you pay it ALL.
POS - Similar to HMO but "some" out of network benefits maybe 60% coverage if that so you get 500 in routine blood thats quite a bill.

Hope this helps a little I can always answer more if you would like let me know.. .. ..

 

[Uppsala9496]

You are going to pay a LOT for an individual plan. COBRA is an option, but again, will cost a bit (and is only a short term solution).
Your current group plan may be your only viable option. The cost is high, but I would venture to guess an individual plan will be significantly more.

 

[Liviathan]

Individual plans ussually cost more compare to when you worked. So take that into consideration.