Is health insurance for the self-employed becoming extinct?

[LiberalHeart]

http://newsgrinder.blogspot.com/2007/03/is-health-insurance-for-self-employed.html

Among things brought out in the article:

In CA, a decade ago one broker had 142 clients offering insurance to the self-employed. Now: three.

The rising number of uninsured folks in this country over the past decade (it's now up to 45 million) was "fueled in part by the dearth of affordable options for the self-employed, experts say. Among uninsured workers, nearly 63% are self-employed or work in small firms, Todd Stottlemyer, president of the National Federation of Independent Business, told Congress recently."

How much more dire does the insurance situation in this country have to get before we DO something about it?

[Tandalayo_Scheisskopf]

1. The insurance companies...

Have inordinate influence, due to the fact they drop huge sums in elections.

[Uben]

2. You can get insurance anywhere

I am self-employed, and I have no problems with insurance for me and the wife. A thousand bucks a month will get you a $5000 deductible amd you pay 50% of the next $10,000! And, as you can see, you can only pay a max of $10,000! What a deal!

[whistle]

4. How often have you been sick enough to submit a claim?

....If you have submitted claims, how much was your share compared to what the insurance actually claimed to pay? I guarantee that if the insurance share exceeded 60% of what your premiums were, you would have to sue them to get the balance and you would become uninsurable. Health insuarnce companies are for profit and they will never give up their profit margin.

[Jackpine Radical]

7. That'sfair because you have lived your life wisely.

You are wise enough to be young, healthy, and in the low-risk category with no prior conditions. Just make sure you wisely remain in all those categories, and you'll be set for life.

[Donnachaidh]

9. try getting it with pre-existing conditions

It's NOT AVAILABLE for ANY price.

[LiberalHeart]

10. I applied for what sounds exactly like that policy. Was turned down last week.

[Raven]

3. Individual health insurance is difficult to find

and very, very expensive. I pay almost $900 a month for a policy just for me.

[OhioChick]

5. I'm sure you can imagine the cost

if you have a chronically ill child. :(

[Sweet Freedom]

6. I don't think it matters anymore if you even have insurance

because it seems they aren't going to pay for anything.

My mom owns a small shop that caters to women with cancer. She has had to drop numerous insurance contracts because they will no longer pay for anything. For example, reimbursement for a wig for someone with alopecia is 40 cents. Forty cents! And to top it off, this particular insurance company no longer has a contract with anyone in Houston, so heaven forbid if you have cancer and would like insurance to pay for your wig. You have to drive outside of Houston to find one.

Then, if you've had a double mastectomy and need two breast prosthesis, insurance will only pay for one and you have to appeal for payment of the second.
:wtf:

Finally, Medicare has just issued a new rule: if you file for Medicare reimbursement for someone who does not have Medicare, you lose your Medicare provider number. Now, on the surface, this seems reasonable to prevent insurance fraud, but in reality this happens: Your grandma has Medicare, but someone calls her and convinces her to switch to Medicare HMO because it is cheaper. She thinks it's the same thing, so does it. Then she comes to my mom's store, presents her regular Medicare card, receives service; mom bill's Medicare and loses her number and with it, her business.

It's just nuts.

[LiberalHeart]

12. I had reconstructive surgery after double mastectomy, then got sick from implants. THEN...

...when my doc said I needed to have them removed (which I was all for, believe me), the insurance company said nope, it was COSMETIC surgery. Yeah, right. Going back to a flat, even concave, chest certainly made me look a whole lot better.

I got a lawyer who pointed out to them that mastectomy patients could get reconstructive surgery -- and what I wanted was to have my post-mastectomy chest reconstructed. They caved at that point and let me get the explant.

[SmokingJacket]

8. Probably the main reason my husband got a "real" job to

supplement his self-employment. It was hard to get insurance even ten years ago -- we paid into the last insurance program available to us for YEARS AND YEARS and never met the deductible. So we paid for everything out of pocket AND forked over tons of money to Mutual of Omaha. Of course I'm *grateful* we were so healthy those years that we didn't meet the deductible, but yipes, did they ever rake in the profits from us.

Now we're lucky enough to have good insurance through an employer -- what a relief, I can't tell you.

[Autumn Colors]

11. My policy is a little over $300/month

Anthem-Blue Cross Blue Shield "Blue Care Direct"

You aren't required to have a primary care doctor and don't need to get any referrals to see a specialist. Copays are $20 to see a PCP or $30 to see any specialist in their network (and I find that most doctors around here are in their network). This includes a 3-tier prescription plan ($10/$25/$40). The deductible is $500.

Just for reference, I'm 45, female, and have generally been in good health (broke a toe last summer and saw a gastro doctor for an isolated case of reflux about 3 years ago, but that's it).

Originally, I joined the Chamber of Commerce to take advantage of their group policy rates, but eventually realized that just buying the above coverage as an individual rather than through my business (since I'm a sole proprietor with no employees) was about 50% cheaper.

I don't know what kind of programs they have in your state, but you might want to check this out.

Oops, forgot link:
http://www.anthem.com/

EDIT # 2: Also, I'm a medical transcriptionist, so I know a lot of the local doctors and usually just go straight to the specialist I need for whatever the problem is.

[LiberalHeart]

13. Did you read about the million dollar fine Blue Cross got in CA?

It was for dropping people for drummed up reasons. Like, you know, getting sick.

My insurance -- for just me and with no Rx coverage -- costs $865. And it's the only insurance I can find.

[Autumn Colors]

14. Ouch!

Well, I'll keep my eyes open for other better companies while I'm still healthy. Thanks for the heads up.

[seabeyond]

15. my hubby wants me to go to work not for PAY.... but for a group insurance

it has become so very sad. our group insurance has risen so last three years looking at individual. those were busts and absurd in what they wanted per what they give. we decided to continue group insurance one more year for our business, monthly bill rising from 900 to over 1200 a month.