Blue Cross, Kaiser are the ones I know about. I have coverage with Kaiser, no wait, I had coverage with kaiser, or do I still have it and still am paying for it????
I had to pay for it since my partner's company has been a pain in the asphalt and messed up with the domestic partnership medical coverage through half of this year. We were paying $250.00 per month (yes that much) plus a co-pay of $50.00 per prescription and office visit. But in January 2005 due to new laws his company will have to insure me medically speaking again by law, so until then I think I am covered and paying.
There are several things you must take into consideration, what all do you want covered? Basic health (that would be without dental and eye) is cheaper the the full nine yards which would include dental, eye and plastic surgery.
If you are not on any prescriptions as a matter of course, then having a higher co-pay for prescriptions is the best way to go, but if you are on several meds you don't want to be spending $50.00 per prescription every month. Right now Kaiser will pay for my prescriptions only if the prescription is over $50.00, then I pay that co pay and they pay the rest.
If there is a pre-existing condition (any on going health issues) your rates will be higher.
http://www.calhealth.net/ may be helpful, it has a form Click on individual family plans, fill out the accompanying form (asked for zip, age and gender of each member, then it will give you a list of quotes.
Now your going to look at all of those less than $100.00 insurance rates and ask "David, why are you paying so much?" I have pre-existing conditions and I stuck with what was similar to what I had since this is all temporary (for me). Not only that but you will note that the less than $100.00 plans only pay for some, not all of the office visit, one will not start paying until you have paid out $4000.00 in office visits for the year, others do not have prescription plans. One pays only 30% of the office visit, Then there is hospitalization where you either don't get any the insurer will pay something like $400.00 per day. Think of hospital stay as being pricer than any Deluxe, 5 star hotel with all the amenities, $400.00 per day is not that much in hospital terms.
I would strongly urge you to sit down with a insurance broker (or would that be sales person?) and have them go over the details, like deductible and what that means to you, and what does "in Network" mean to them and how does it affect you.
America has the lousiest medical insurance in the whole wide world, simply because Insurance is in it for the money and you, as the consumer, will be targeted and lied to so they can sell you a product (coverage).
At that site I gave you, you can click on Benefit details, which opens another page and gives you a break down of what is and is not covered.
In network out of Network is a stupid, er, I mean, polite way of saying within the coverage hospital/offices. For instance, say you go for Kaiser, in network would be kaiser hospital, and County hospital, Out of network would be Doctor's Medical who will take you in an emergency but as soon as you are stable you are moved to Kaiser, or county which ever has room.
Some of the insurance plans will pay for a minimal amount out of network, that means if you are hit by a car and taken to Doctor's medical, you will have to pay for what ever is not covered by Out of Network insurance. The cheaper insurance rates do not cover any of that, so everything you tally up at the out of network hospital you will pay out of pocket.
When dealing with insurance people make certain that their "in network" is around and near you.
What is Deductible?
quote:
How do deductible plans work? (Individual and Family Plans)
The deductible is a calendar year deductible: January 1st – December 31st .
After you have paid in medical bills the amount equal toward your deductible, then the insurance pays 80% and you pay 20% until you reach your “out of pocket maximum”. After you have paid out the out of pocket maximum for any calendar year then the insurance pays 100% up to the lifetime maximum.
Example: If your eligible medical costs for the year total $30,000 for a covered person, and you’ve chosen the $1,000 deductible BlueCross BlueShield plan.
· You pay your deductible ($1000).
· You pay 20%, and the plan pays 80% of the eligible charges until you reach your out-of-pocket maximum ($1800) – your deductible plus your co-insurance of 20%.
· Then the plan pays 100%.
You would have paid - $1800
The plan would have paid - $28,200
http://www.mnhealthnetwork.com/answers.htmPerhaps that site has more information that may be handy in choosing a health insurer
David
