I am self employed and pay individual insurance rather then traditional employer plan. I was wondering what is the most recognizable health insurance name out there. I currently have Kaiser and BCBS. I had to make a trip to an ER today for a minor procedure but they said Kaiser is not accepted. Just looking for some insight from others possibly in the same situation.

Serious response: If you can afford it, stick with BCBS; it's the gold standard for health coverage.

I always had a hard time understanding health insurance plans. I have been with bcbs for over 2 years now but looking at Aetna and united health one as a possible alternative.

They should accept Kaiser for a true emergency visit and coming there was necessary. If it was something that could have otherwise been scheduled or you could have gone to a Kaiser facility then maybe that's why.

Aetna is widely accepted. Not cheap either though without a high deductible (and still not really cheap). Less than Kaiser though when I've looked at least.

What would you consider "not cheap"? I have seen plans with a $1500-2500 deductible going between $130-200 a month, some include basic dental as well. Seems like all of my friends that have insurance plans through their employer tend to pay around $300 or more for an individual plan. Am I missing something here?

Previous poster is correct about Kaiser. I had them about 15 years ago 3 employers back. They keep costs, including your costs, down by making you go through their GPs first. The exception is like previous poster said when you have an emergency annd have to go to the ER; then they pretty much have to cover you.

20some Wrote:
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> What would you consider "not cheap"? I have seen
> plans with a $1500-2500 deductible going between
> $130-200 a month, some include basic dental as
> well. Seems like all of my friends that have
> insurance plans through their employer tend to pay
> around $300 or more for an individual plan. Am I
> missing something here?

They're in group plans. If you're in your 20's, you might pay a lower premium for now. Go to BCBS/Anthem site. You can modify your premium by how you configure deductible, coinsurance, co-pay, and annual benefit maxium.

20some Wrote:
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> What would you consider "not cheap"? I have seen
> plans with a $1500-2500 deductible going between
> $130-200 a month, some include basic dental as
> well. Seems like all of my friends that have
> insurance plans through their employer tend to pay
> around $300 or more for an individual plan. Am I
> missing something here?


No, I missed that you were 20something. My individual plan for an older guy with a high deductible is a lot more than that. Enjoy it while you can.

You'd have to go to their sites and look and see what they're charging given all of your particulars. There are some comparison sites that list various providers but they probably won't have Kaiser or BCBS and I'd stay away from any with names that you don't recognize. Some of those are cheap but have very limited providers. I made that mistake once.

If you are self employed HMO will be the most affordable for you. We have BCBS as my wife is a Fed. Its okay but very expensive. Each year the remove more and more coverage. We have 2 kids and I would say our annual medical out of pocket is about $9,500 including premiums, co-pays, scripts and dental.

I loved my Kaiser plan when I was self-employed. The facilities are clean and not overrun by illegals. Getting a appointment was easy. I had elbow surgery and it cost me $20 out of pocket.

The business model for health insurance is to collect as much in premiums as possible and pay out the least in claims as possible (they employ thousands of claim deniers). The spread is their profit. That's what you get when medicine is for-profit. This stinking country is the only (developed) one that allows this scam.

That said, health insurers are very good at jewing down the hospital/medical racketeers. They will often negotiate significant discounts on what you end up owing.

Kaiser is good. But you must go to their facility first.

LetsRock Wrote:
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> I loved my Kaiser plan when I was self-employed.
> The facilities are clean and not overrun by
> illegals. Getting a appointment was easy. I had
> elbow surgery and it cost me $20 out of pocket.


I liked Kaiser too when I had it. The quality of the staff and facilities was great I thought.

One of the best things about it versus other options is that you don't have to run all over the place when you need to see some specialist or for tests. Need blood work done - 3rd floor. See the eye guys - second floor. Internal medicine - 5th floor. Now I have to go to a primary care guy in Fair Oaks, testing center in Vienna or wherever, wait another week to haul some place else to see some specialist who's on their approved list, etc., etc. Pain in the ass.

And very few if any damn forms and all of the crap that comes along with that as far as approvals and billing. Pay the monthly and your co-pay and you're pretty much done with it.

Also when I had kids at home if they're sick or hurt after hours, you can just head on over instead of having to try to make an appointment the next day and going through all of that.

Not great I guess if you have your own doctor that you like but that's not even been a remote possibility for me with all of the various changes to insurance plans with jobs and moves over the years.

We have BCBS and have been pleased with the availability of providers and level of service. However, my husband just switched to a different 'flavor' BCBS and I have some concerns. For instance, under this plan, we have to go to Reston or Tyson's to have blood drawn, which is a pain in the neck. But I love being able to see different providers without having to get a referral.

Health insurance is pretty much a crapshoot. You probably won't know what isn't covered until you make a claim.

BTW, dental insurance has all kinds of weasel clauses to get out of paying for things that should be covered. God forbid a root canal or crown fail within two years (through no fault of your own) - you're on your own. Thousands of dollars later...

If you're shopping, ehealthinsurance is a respected, objective tool to compare companies and policies. It also has a lot of general information about definitions and claims.
http://www.ehealthinsurance.com/