What are you doing about health insurance?

https://news.ycombinator.com/item?id=30544

by djworth • 19 years ago

11 18 19 years ago

news.ycombinator.com

djworth2• 19 years ago

I'm in the early stages of starting my startup and I'm interested to hear how others are obtaining health insurance.

nostrademons• 19 years ago

Keeping my day job. ;-)

Once it's time to leave, I'll probably get catastrophic coverage in case I get hit by a bus or end up with cancer, and pay for routine expenses out of pocket. Healthy people in their 20s really don't have many medical expenses - I think the last time I went to the doctor was a year and a half ago, and it cost about $150 (through a COBRA mixup, my coverage didn't start until the month after I needed it, but they refunded my check for the month I wasn't covered and I ended up saving like $200 by not being covered). If there are serious problems, that's what the catastrophic insurance is for.

dshah• 19 years ago

This is not a luxury. Get some competing quotes from small business health insurance providers in your area and pick one.

djworth2• 19 years ago

Dig. That's what we're doing. Thanks for the comments I guess I just needed the YC warm and fuzzy.

jward• 19 years ago

Staying in Canada ;) The downside is not being around silicon valley and not having access to a like minded support network in person.

luxiou• 19 years ago

If you live in one of the qualifying states (CA is included), http://www.tonikhealth.com has fairly reasonable quotes for "catastrophic" insurance -- $77/mo for their base plan.

jobenjo• 19 years ago

I was going to do Tonik ended up being advised by a professional not to. The important thing with all these cheap plans (I have one now around a $100/month) is to make sure they don't just cover generic. If you get really sick and need special drugs--which don't have generics--you're out of luck.

If you live in CA, I'd recommend talking to someone at allhealthplans.com. It's free (the insurer pays them), and they have great information about all the competing companies--no bs, excellent help. I've sent lots of people their way.

zach• 19 years ago

We actually went to a good old-fashioned business insurance agent. We got a reference from someone who was happy with theirs.

Me and my founder have a Blue Cross HSA plan that costs around $150-$200 per month for a single employee. It's $200 if you want the HSA-minimum $1500 per year deductible. After the deductible is met, PPO network expenses are entirely paid by the plan, and before they're met you get PPO discounts. I recommend it.

We have the advantage of being in California, an extremely favorable environment for small businesses (2-50 employees) to get group health plans in. Couple things worth pointing out about our situation:

- It's an honest-to-goodness group plan, not an individual plan. Individuals have health coverage at the pleasure of the insurer. Those lovely stories about insurers (like Blue Cross) cancelling policies retroactively happen to people with individual plans.

- In California, insurers can't refuse to insure a small business based on employees' health or medical history. Do you know how difficult it can be to get individual insurance with less-than-average health, much less an actual medical condition? Basically, forget it. Small businesses in CA have no such problem. Even though we're healthy, it lets us actually rely on our health insurance.

- Also in California, insurers are limited to charging no more than 10 percent more than an index of what they charge large businesses, based on the employees' health. It's a great deal for small businesses. And again, it makes things very predictable even in a worst-case scenario.

- As a C corporation, we can deduct the premiums we pay as expenses. Some, especially S corps and LLCs, may not be able to -- in any case, consult your tax advisor.

- We can hire someone tomorrow and offer a health plan that we don't have to be ashamed of, and it's flexible. If we need to share costs, we can pay only half or most of it and deduct the rest. If we can afford to offer a premium health plan, we simply pay the premiums and fund their HSA every month.

davidw2• 19 years ago

Living in Europe. There are a whole slew of reasons why Europe is worse for startups, but this is a point in Europe's favor.

Tichy• 19 years ago

It is? I am in Germany and I was actually wondering if it would be possible to get insurance from a foreign insurance company. The "public health insurance" is REALLY expensive for me (500/month), but I don't see a way out.

dbl• 19 years ago

We use http://www.cose.org. There's probably a similar organization in your region.

ryanpharis• 19 years ago

I was just wondering this same question today. Thanks for the great advice.

gyro_robo• 19 years ago

http://www.ehealthinsurance.com/

It shows you what coverage is available where you live.

Definitely get health coverage. Even with a deductible on a PPO plan, you still pay LESS than if you didn't have any coverage, because your insurer negotiates with hospitals in its "network" so your rates are cheaper. That is, they don't cover your deductible in any way but the in-network hospital gives you e.g. 20% off because the Insurer made them agree to it.

People who have no insurance who DO pay get billed more to make up for the people with no insurance who don't pay. Health coverage is like paying union dues; large insurance companies have clout, unlike individuals.

davidmathers• 19 years ago

+1 to ehealthinsurance.

First, think of your health insurance plan as actual insurance, meaning something you will hopefully never have to use except in case of catastrophe. All your normal medical expenses will go through your HSA.

Search for HSA plans with high deductibles ($3k to $5k) and 0% co-insurance. Prices for such plans here in San Francisco are $75 to $110 a month. I chose the $75 option from HealthNet.

Then set up your HSA account. I use hsabank.com, but there are many options. Auto-fund your HSA account with $100 to $200 a month depending on your needs and pay all medical expenses from the account.

When the balance of your HSA account matches your deductible ($3k to $5k) then re-evaluate your monthly funding amount so it more closely matches your actual monthly expenses.

kingnothing• 19 years ago

I also use ehealthinsurance.

asdf333• 19 years ago

If you are young and relatively healthy, i suggest going w/ disaster insurance (really cheap insurance w/ a high deductible)

Get advice for small colds from med school friends, and get insurance only for those cases when you are hit by a truck because you were too busy writing code in your head to look both ways before crossing the street.

That is what I did. It worked out mostly. Had to pay for one thign out of pocket, but it wasn't too bad.

Readmore• 19 years ago

I went with Assurant health (www.assuranthealth.com) because I need maternity coverage for my wife.

What are you doing about health insurance?

Related Stories