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Health Insurance Dilemma

CUPCAKE

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Once your self employed what are some valuable lessons you learn through trial and error on navigating healthcare in the US. The open enrollment season for healthcare marketplace is almost ending but none of their plans are as impressive when we are in the young and healthy age group. Even if we weren't what would be a valuable health cost you would take on? Anyone here using HSA?
 
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Harbourmaster

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Hi @CUPCAKE,

Welcome to the forum, great to have you! Congrats on being at the point in your business where you are ready to start looking at health care options. Are you full-time or do you have a job as well? Is this for you only? A spouse? Are you hiring employees? I think I read on your other post that you own a Shopify store, is it generating profit at this point? Tell us a little bit about yourself and your business and maybe you will get some feedback on next steps.

Or is this more of a "what if..." type request? As in, something you are trying to figure out before you need it. Like, "what if my Shopify store gets super successful, what type of coverage will I need?"
 

GigMistress

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Once your self employed what are some valuable lessons you learn through trial and error on navigating healthcare in the US. The open enrollment season for healthcare marketplace is almost ending but none of their plans are as impressive when we are in the young and healthy age group. Even if we weren't what would be a valuable health cost you would take on? Anyone here using HSA?

First, a word of warning. A couple of years back, I looked at the dismal offerings in my area and decided that it would be more sensible to fund my own healthcare (which rarely exceeds a couple of thousand dollars a year) than to pay $1000+/month in premiums for coverage that would still leave me paying most expenses out of pocket.

Of course, I knew there was a risk if I was suddenly diagnosed with a terminal illness or something, but here's the risk I didn't anticipate: I could not find a doctor who would see me to prescribe my ongoing blood pressure medicine without insurance. I called every provider in my area, and negotiated in every way I could think of, including offering a $5,000 deposit against future billings to reduce their risk. No dice.

Of course, I make far too much money to be able to go to the type of clinics that usually solve this problem for the uninsured, and walk-in clinics as a rule don't dispense maintenance medication. I went through a year of hell, frantically shopping around every couple of months for someone to refill my medication, sometimes having to drive an hour to a clinic with a pharmacy that would give me a one-month refill or see a PA at the one not-for-profit that didn't have income guidelines (but made me feel awful to use, because it was obviously a service for people in very different circumstances than mine, and they didn't even have a sliding scale--I couldn't pay them more than $20) but closed in the middle of that year.

Long story to illustrate that being uninsured became a huge obstacle despite having no significant health issues during that year and having plenty of money to pay cash for routine medical services. I wouldn't risk it again.

On a more solution-oriented level, does anyone else work with you in your business? I operate as an LLC and employ one person and am able to get group coverage for the two of us. It doesn't save much on premiums, but does really open up the options.
 

NMdad

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First, a word of warning. A couple of years back, I looked at the dismal offerings in my area and decided that it would be more sensible to fund my own healthcare (which rarely exceeds a couple of thousand dollars a year) than to pay $1000+/month in premiums for coverage that would still leave me paying most expenses out of pocket.

Of course, I knew there was a risk if I was suddenly diagnosed with a terminal illness or something, but here's the risk I didn't anticipate: I could not find a doctor who would see me to prescribe my ongoing blood pressure medicine without insurance. I called every provider in my area, and negotiated in every way I could think of, including offering a $5,000 deposit against future billings to reduce their risk. No dice.

Of course, I make far too much money to be able to go to the type of clinics that usually solve this problem for the uninsured, and walk-in clinics as a rule don't dispense maintenance medication. I went through a year of hell, frantically shopping around every couple of months for someone to refill my medication, sometimes having to drive an hour to a clinic with a pharmacy that would give me a one-month refill or see a PA at the one not-for-profit that didn't have income guidelines (but made me feel awful to use, because it was obviously a service for people in very different circumstances than mine, and they didn't even have a sliding scale--I couldn't pay them more than $20) but closed in the middle of that year.

Long story to illustrate that being uninsured became a huge obstacle despite having no significant health issues during that year and having plenty of money to pay cash for routine medical services. I wouldn't risk it again.

On a more solution-oriented level, does anyone else work with you in your business? I operate as an LLC and employ one person and am able to get group coverage for the two of us. It doesn't save much on premiums, but does really open up the options.
I'm in a sorta similar situation--self-employed with an s-corp--and for myself, wife, and 2 kids--all relatively healthy, we pay over $1,400/month in premiums. F'ing crazy. Yeah, other countries might have high tax rates, but people there don't pay insane health insurance & care costs.
 
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Ing

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Germany. My 4 head family pay about 1600€ a month.

And her so having money doesn’t need an insurance to get the best med.
 

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