Ask HN: Startups and independents, what do you do about health insurance?

https://news.ycombinator.com/item?id=2824627

11 15 15 years ago

news.ycombinator.com

I am not working for a BigCorp for the first time in my life, and I have not had health insurance or benefits since leaving my last employer. Given that there are a lot of small startups and independent contractors on HN, I am seeking advice on the best options for insurance and benefits.

Who offers this to individuals or very small companies?

jbhelms• 15 years ago

If you have a Tax ID and at least two people that want the insurance, you can get a small business policy. Just do a google search for brokers.

yummyfajitas2• 15 years ago

I'm taking my chances.

I've already moved halfway around the world (my startup needs cheap labor) and run a much higher risk of death than in the US. Why should I worry about a financial hit on top of death?

(Amusingly, my Mom worried about the Mumbai bombings 150km away from me. In reality, she should worry about me looking the wrong way while crossing the street.)

badclient• 15 years ago

You moved to my home city, Mumbai? :)

It's an awesome city though not always cheap. More likely you're somewhere else in India hopefully!

yummyfajitas2• 15 years ago

Pune, not Mumbai. But I described Pune to her as "a satellite city of Mumbai".

jasonkester2• 15 years ago

Look into IMG Global. They'll give you catastrophic coverage for less than $100/month anywhere in the world, thus eliminating any possibility of "financial hit".

Low deductible group coverage is mostly useless if you're young and healthy. High deductible "Don't ruin my life if I get hit by that taxi and only break my hip" insurance is absolutely worth it.

dlapiduz• 15 years ago

I used to have an international insurance with bupa.com. They are very good and not that expensive but I believe you need to have an address outside the US

jmtame• 15 years ago

In SF here and just signed up for individual health insurance, HealthNet PPO ($70/month) after getting recommended to an agent through Dave Ramsey's web site. It's a high deductible plan (around $7,500), but the premiums seem low. I personally feel less at risk of being in the hospital; I don't commute right now; I'm a fairly healthy individual. I would have signed up for the Health Savings Account, but it was a bit more expensive. Maybe later.

tirrellp2• 15 years ago

I have an Anthem Blue Cross (California) family plan. It has a high deductible (7500), and is attached to an HSA. Most normal routine preventative maintenance is covered. My premium is $200/month. I treat this plan as 'major medical' and sock away as much money as possible into the HSA, which I use for EVERYTHING I CAN.

As an interesting side note. I was talking to my doctor, who happens to have the same health insurance as me. He said that I am better off using my HSA in most cases. For example, his practice charges $130 for a routine visit if I pay directly from the HSA. If I charge it to my insurance, its more like $1300. Why? 1, because dealing with insurance, by his own admission, is a PITA, and 2, he will ALWAYS charge the maximum that will be covered by insurance... its how business is done. But for cash (HSA) payments, the administrative overhead is so low and the risk factors for nonpayment (insurance denies the claim, etc) are so low and the A/P cycle is so short, he would rather get paid $130 NOW (on my way out) than get $1300 90 days net IF insurance approves the claim. He said a lot of doctors and dentists do it this way and I should ALWAYS ask 'whats the cash price' because some have tiered rates like he does. Most people don't care that its cheaper to pay cash because for most people, their primary concern is out of pocket expense. Most people would rather charge their insurance $1300 so long as they don't have to pay anything than to pay $130 and not 'overpay' (albeit opaquely)

lawnchair_larry• 15 years ago

Interesting. I would have guessed the opposite - that the insurance companies get a "volume discount" of sorts.

What about with prescriptions? Is it better to pay cash price via HSA, or can you get a cheaper rate through your provider?

jasonkester2• 15 years ago

Think about the definition of Insurance. It's money you set aside to cover the costs of a low-percentage, high-cost thing.

Now think about what the Health Insurance industry wants you to think is the definition of Insurance: In addition to the above, pay us all the money you'd normally save for cold medicine and doctor visits and we'll give most of it back to you when you need it.

They're not the same thing, and if you're paying for the 2nd one and not using it every month, you're going to come out worse.

tirrellp2• 15 years ago

As far as prescriptions, I have a couple cost effective choices: Compounding Pharmacy and Mexico. The compounding pharmacy that my doctor referred me is very reasonable and they can 'custom make' drugs. Mexico is a very good option (I live in San Diego) because I can go get a generic equivalent for 1/5 to 1/10 of the price in the US, and I can use my HSA card to pay for drugs in Mexico.

nhangen2• 15 years ago

I bought a Blue Cross Blue Shield plan privately. For less than $500, I got full dental and medical, including maternity, for my wife and 3 children.

PonyGumbo• 15 years ago

That's excellent - what state are you in (if I may ask)?

nhangen2• 15 years ago

I'm in Florida, where I hear Humana has great plans as well.

veyron• 15 years ago

If you are a US citizen, you have COBRA coverage. Which can get pricey, but at least its something.

How old are you? My parents health/dental/vision coverage extends to all children until 26, and I think one of the benefits of Obama healthcare overhaul is that all health care plans must cover children until 26.

Ask HN: Startups and independents, what do you do about health insurance?

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