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Health and Medical Issues For other than injuries

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Old 03-22-2011, 10:37 PM   #1
Yahya Kohgadai
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choosing health coverage.

If someone anticipates having some somewhat serious issues that might require regular treatment and maybe even surgery, which one would they go with?
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Old 03-23-2011, 08:13 AM   #2
Jeffrey Liu
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Re: choosing health coverage.

This is an extremely broad question without an easy answer.

Are you looking in the individual market, or are you provided coverage options by your employer? What kind of plans do they offer?

Do you intend on seeing specialists more often than primary care physicians?

Do you have enough personal income to cover X dollars for a deductible?

Have you been treated for said "serious issues" before? If so, unless your current coverage is totally awful I'd shy away from switching insurance providers. More than likely you'll end up being diagnosed with a "pre-existing condition" and will have to wait anywhere from 30-90 days once signing onto your new plan before the company will cover any claims related to this condition.
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Old 03-23-2011, 02:42 PM   #3
Yahya Kohgadai
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Re: choosing health coverage.

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Originally Posted by Jeffrey Liu View Post
This is an extremely broad question without an easy answer.

Are you looking in the individual market, or are you provided coverage options by your employer? What kind of plans do they offer?

Do you intend on seeing specialists more often than primary care physicians?

Do you have enough personal income to cover X dollars for a deductible?

Have you been treated for said "serious issues" before? If so, unless your current coverage is totally awful I'd shy away from switching insurance providers. More than likely you'll end up being diagnosed with a "pre-existing condition" and will have to wait anywhere from 30-90 days once signing onto your new plan before the company will cover any claims related to this condition.
I'm self-employed so it won't be through an employer. I'd like to have the freedom to see specialists and not just my general physician.
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Old 03-23-2011, 06:44 PM   #4
Frank E Morel
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Re: choosing health coverage.

Your looking for a ppo plan. Self employed.....hmmmm. It's not going to be cheap. Look at pacific care, unitied health., blue cross of California. Or you could go with either the no frills plans of medi cal or San Francisco county plan if you live within sf county and are no about a set salary amount.

Failing that it the gate keeper HMO .....kaiser. Cheap monthly but big co pay. Or. Big monthly and cheaper co pay. But you are restricted to whom and when you see someone within kaiser.. Ie. You want pt, the primary has to see you and feel that there is a true need for pt... You then go see the pt. And they decide it's real a pt issue.. Lots check stops on the way.
But their price plans are like a cafeteria You pick what you think need and hope that you never need it
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Old 03-23-2011, 09:15 PM   #5
Yahya Kohgadai
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Re: choosing health coverage.

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Originally Posted by Frank E Morel View Post
Your looking for a ppo plan. Self employed.....hmmmm. It's not going to be cheap. Look at pacific care, unitied health., blue cross of California. Or you could go with either the no frills plans of medi cal or San Francisco county plan if you live within sf county and are no about a set salary amount.

Failing that it the gate keeper HMO .....kaiser. Cheap monthly but big co pay. Or. Big monthly and cheaper co pay. But you are restricted to whom and when you see someone within kaiser.. Ie. You want pt, the primary has to see you and feel that there is a true need for pt... You then go see the pt. And they decide it's real a pt issue.. Lots check stops on the way.
But their price plans are like a cafeteria You pick what you think need and hope that you never need it
Well, I'm willing to pay more monthly and assume that I might really need it. W/that said I should probably go for a PPO then?
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Old 03-24-2011, 09:11 AM   #6
Katherine Derbyshire
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Re: choosing health coverage.

Get married to someone with good insurance.

I'm only half joking. Self-employed insurance plans for people with actual medical needs get very expensive very fast.

If you're a member of any professional societies or similar groups it would be worth investigating to see if they have a coverage plan for members. Shopping on your own in the open market, well... Also, get informed about California's implementation of Obamacare: you're exactly the kind of person it's intended to help. If you have a specific condition in mind, you'll also want to search the internet for support groups for people with that condition.

Since you are expecting to actually need the insurance, read the contract very carefully to see when they are allowed to raise your rates or cancel your insurance. Assume that they will try to do so, and make sure you jump through whatever hoops are required, and *document* that you have done so.

Katherine
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Old 03-24-2011, 09:45 AM   #7
Yahya Kohgadai
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Re: choosing health coverage.

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Originally Posted by Katherine Derbyshire View Post
Get married to someone with good insurance.

I'm only half joking. Self-employed insurance plans for people with actual medical needs get very expensive very fast.

If you're a member of any professional societies or similar groups it would be worth investigating to see if they have a coverage plan for members. Shopping on your own in the open market, well... Also, get informed about California's implementation of Obamacare: you're exactly the kind of person it's intended to help. If you have a specific condition in mind, you'll also want to search the internet for support groups for people with that condition.

Since you are expecting to actually need the insurance, read the contract very carefully to see when they are allowed to raise your rates or cancel your insurance. Assume that they will try to do so, and make sure you jump through whatever hoops are required, and *document* that you have done so.

Katherine
Good insight, thanks. Define expensive though, would it be under $400/month?
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Old 03-24-2011, 10:37 AM   #8
Katherine Derbyshire
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Re: choosing health coverage.

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Originally Posted by Yahya Kohgadai View Post
Good insight, thanks. Define expensive though, would it be under $400/month?
I haven't priced California insurance plans, so I can't say. You can probably get a basic plan for less than that, but more comprehensive coverage can easily be twice that much. And again, any hint that you might actually get sick will cause your cost to rocket upward.

Katherine
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Old 04-07-2011, 05:28 PM   #9
Frank E Morel
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Re: choosing health coverage.

Call pacific care. Or untied healthcare
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