Hello,
I have a question about the healthcare insurance in US.
I have heard that it is tied to your employment and the company provides for it.
So here are a couple of questions:
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Is there no way for an individual to get their own personal insurance and not be dependent on the company?
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What about freelancers, business owners and retirees? Do they forfeit their insurances?
Yes, individuals and self-employed persons can buy health insurance on the health insurance marketplace. Since you’re one person buying a plan you don’t have the ability to negotiate with health insurance companies the same way a corporate employer buying policies for many people can negotiate. This means individual plans are expensive and coverage is often lacking, but it’s still better than ending up with cancer or a massive car wreck and being without insurance.
There are also government funded plans like Medicare, Medicaid, etc and I have never dealt with those. Have been a self-employed contractor though. A policy I paid $600/mo for as an individual, self-employed contractor costs about $200/mo for a plan with better coverage for both my husband and I through his corporate employer plan.
Oh wow. That’s 3x different.
You can get insurance through the national marketplace, this was put in to effect with the ACA. The biggest problem with that though is the cost can be insane (single person, $800+ month). Usually why people go through the company is it is much cheaper (I pay about $60/month premium for just me).
It is usually cheaper because either a company “self funds” or they have a large number and better leverage with insurance companies. If you’re a business owner, you work with brokers who will try to find you the plan that best suits you or your company’s needs. Finally retirees will either have insurance through their pension, or will use Medicare which is another government provided insurance for people over 65.
I know that probably raises more questions but hopefully that’s a start.
That does sound deceptively hard for individuals to be not dependent on a job for them to qualify for proper healthcare in the US though.
Pricing you out of your own care is pretty hard to hear.
You can buy insurance as an individual but it’s usually rather expensive.
Healthcare.gov (Obama Care) has a marketplace one can compare and purchase plans & take government assistance if they qualify.
Where I am, companies provide protection which are generally pretty okay. But everyone still gets personal ones, and they do not cost too much. Perhaps, 50-100? And tend to cover the gaps the organisation’s sometimes don’t.
Oh, and you do not have to pay extra for the company’s. It is part of your remuneration package. (we get paid less though).
In the states I’ve worked for companies that paid the entire thing and I had no bill for insurance, and others that paid less. It is one of the things people consider when looking at a benefits package for an employer.
Health insurance for an individual is expensive. Even if you pick a plan that is cheaper, it is going to have a significantly higher deductible and out of pocket cost for care, and likely less flexibility in providers, medications, and covered services, so you can get less and spend more money before they even start paying. I checked individual plans through the same company that my employer-provided insurance is though, and for the same premium (my portion) the deductible is six times higher and the maximum out of pocket was over 4.5-times higher.
This isn’t necessarily because individuals are getting screwed by the insurers. Employers often pay a significant amount, $1000 or more isn’t unheard of. Usually people find out just how much when they leave a position, the employer offers them cobra coverage which lets them keep their insurance for a while but they have to pay the full amount, and it is a jaw-dropping number.
To add to this, always contact the hospital and ask for an itemized bill. Getting that bill can be the difference between owing hundreds of dollars vs thousands.
Some hospitals will also have different scales for how much you have to pay based on income. Make sure you find out.
