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I quit! Now... what am I going to do about health care?

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Yesterday was my last day at work. It's a complicated story about "not giving 100%" and needing to spend way more of my percentages here at home on my kids. I'm starting a new freelance career that will pay a lot less than my former career, and naturally, includes only the benefit of complete freedom from externally-imposed responsibilities. Health insurance and maternity leave and retirement? I'm hoping my good, nourishing cooking and royalties from my soon-to-be-pitched book will cover me. (It's good to think positive.)

I can't afford Cobra and I think my income will be too high to qualify for the Oregon Health Plan (though maybe I'll be close). We get supplemental insurance through the Army Reserve's Tricare program for $82 a month but I doubt it'll help me without the primary insurance. I'm considering just paying out-of-pocket for services we need (like well-baby visits and the occasional checkup for Jonathan and myself, plus dental visits). Compared to the retail price of health insurance for my family -- between $400 and $1000 a month, plus deductibles and co-pays -- a few hundred here and there doesn't seem that bad. And honestly: I'll bet my out-of-pocket costs with employee-sponsored United Healthcare were at least $2000 in the past year.

Of course, that's assuming that I don't have another emergency like the one where Monroe ended up riding the ambulance to get stitches in his eye. And I have three extremely energetic and risk-loving boys. When I tweeted about my quandary over insurance, I found a few other mamas responded back almost immediately; they, too, were foregoing insurance due to great expense. We've talked before about insurance providers and insurance for pregnant mamas (thank goodness that's not a factor for me right now). While this is a great time to get very, very angry over the state of our nation's health system (John McCain accused Barack Obama's plan of being like England's -- I thought to myself, if only!) -- it's also a time to evaluate the options in reality. For those of you who don't get, or can't afford, insurance through your work or your spouse's work: What do you do?

Update: I wrote a post on WalletPop about "The Gilbert Plan," the way health care policy should be. What do you think about that?

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What a timely post! I am in much the same boat, having quit my regular, benefitted job this summer to pursue my dream of being a photographer. I supplement my income with temp work, but neither pursuits come with benefits! (My son is covered through his dad though.)

I went with the keep-my-fingers-crossed method, but did end up with a substantial ER bill unfortuntely, just a few days after my eligibility for COBRA ended. Oregon Health Plan tells me they have no spots for non-pregnant adults.

So, I don't have an answer but am beginning to realize that I need to have the insurance, even if it means putting it on a credit card for the time being. There are freelance and professional associations out there that you can join and be eligible for group benefits. Not cheap, but possibly better than retail insurance. For now I'm going to look into that option, but I am hoping some of the mamas here have some suggestions!

I went through this issue awhile back, with my COBRA costs being $1500/month for 4 of us. Crazy. We found a plan working with a broker (Holly Worthington, I highly recommend her) for about $400 for my husband and boys, and then I had to COBRA myself because I was turned down for the individual plan (don't get me started on that!). So, I can share a little of what we learned in this process, for what it's worth. First, if you have any kind of pre-existing conditions and you go 61 days without coverage of any kind, you can be denied coverage for these things in the future. Something to consider. Also, the income guidelines for children to qualify for the Oregon Health Plan are different than for adults. You may find that they get covered even if your whole family cannot. I completely get the desire to gamble on not having insurance, particularly if you think it's short term. But, long term it can be different. I don't know the details on how they work, but maybe a formal health savings plan could work for you? I would also say to consider how much biking you do and whether or not the risk seems greater given that. For the "but you take a risk in your car" argument, that is true, but I have auto insurance to pay for injuries sustained in my car. We went for just under the 61 day mark without insurance at one point and I held my breath every day because my husband is a bike commuter.

So, here's the way I balance it. I pay for health insurance because it's just a gamble I don't want to take today. But I don't actively contribute to my retirement right now. When my kids are older and I find that I can work more, I will.

Good luck to you as you figure all this out. May the benefits of this kind of situation outweight the insecurities for you.

My husband and I have been self employed for over 7 years now. The first month that I was uninsured, i went snowboarding for the first time and broke my wrist. That is the story of my life. So i bit the bullet and have been paying for insurance ever since - i guess i am used to it now but boy is it expensive. You should really get in touch with an insurance broker - there are many many options out there and they do a good job finding a right fit - balancing care and costs to the needs of your family and finances. We really need to do something in this country though - i really hope the next administration can help.

I'm not sure exactly what it is, but my husband says, "Tell them to check out Starbridge." He says it's what his company offers part-time employees instead of COBRA.

When I was younger, I generally opened lines of credit when I needed to... then again, most of my health care needs were dental, and when I went to the ER, it was payed for by the drunk driver's insurance. Anyhow, I've kept my CareCredit account, and it was useful for some veterinary bills.

When my husband went through a year of under-employment and was at home with the kids, we got a high-deductible insurance plan. I think it was something like a $10K deductible, and we paid around $300/month for 4 of us.

I meant to say, my husband was under-employed and I was at home with the kids. :) Now there are 6 of us. If we had to pay for our own low-deductible insurance it would be more than $1500/month!

We're both self-employed as well and pay for private. We go through Regence of Oregon. The bill hurts big time, but we write it off at the end of the year which helps a little. BTW, this helps us not at all, but Regence is one of the companies that charges a flat child(ren) rate for up to four kids, meaning those of you with multiple munchkins would be paying the same as we do with just one.

Health insurance is absurdly expensive for us, but one bad accident or illness without it and we'd be up a creek without a paddle. I agree with Lori, a broker helped us through our uninsured pregnancy and they get paid by the company, not you.

we are in the exact same boat. when i worked as a teacher we were completely covered as my husband is self employed. i've been home for the last three years. we use to pay healthnet $400/mo. and still had a $2500 deductible. we never even came anywhere near that so i got in touch with a broker who steered us towards a high deductible hsa. we now pay $230 for a 5K deductible. we do have to pay for well baby check ups (really, we pay for everything up to that deductible) but when i did the math it was worth it. the $200 a month we save i use to (wish i still could) put into the hsa and use that money pretax for all med. expenses. that's a savings of $2400 a year and then we usually spend about $1000/yr. on doctor's visits. sometimes i wish we still had the old insurance as i didn't really think twice about the kids' dr's visits since we got 4 "free" ones a year. now i feel like something's really got to be wrong for any of us to go in. i'm interested to see what others are doing. maybe there's a better way out there that i don't know about!

on another note (kind of) it was interesting how much i paid attention to the price of med. care once i had to pay for it myself. before switching over i called our pediatrician's office and went over exactly how much each well baby check up will cost. for example, the two y.o. exam is much more expensive than the 3 y.o (we vaccinate) so i made sure to get the 2 y.o. check up in before we switched. also, my husband hurt his knee at the gym and the exam was around $100 but they wanted to give hime a knee brace for $130! we never would have thought to even ask about that before.

You bring up a really good point that people are always confronted with when either:

a) losing coverage through former employer
b) employer canceling coverage
c) in "waiting period" as a new employee

One viable solution for a number of people is to look at short-term medical (STM) insurance. It is very affordable (compared to COBRA and other individual plans), designed to cover a person (or family) for a short period of time (30 days up to 36 months in some states).

STM will not cover pre-existing conditions. It can be described as "what if I wakeup in the ER" insurance, or the "the hospital called to say your kid was brought in by an ambulance" policy.

I'm not trying to trivialize such things, but hopefully you get the idea that STM coverage is designed to cover unexpected accidents & illnesses.

Wow, I don't envy you for having to figure this all out...probably not the ideal first "project" as a freelancer! I have no idea if this is possible or not, but I'd suggest if there is some way that you can set up an individual HSA with a high deductible insurance plan. My husband is employed in corporate america and the health insurance options are plenty and complicated... But we switched this year from a traditional insurance plan to an HSA where we pay for everything with a debit card tied to the HSA that he contributes to monthly. It's been fascinating to receive all of our bills and see exactly which doctors charge what types of fees vs. the kind of service we felt we received (I've switched peds as a result! and used more chiropractic and naturopathic care this year than ever before). If/when we reach our high deductible (in the event of an accident or unforseen hospitalization) the insurance kicks in and pays about 90%, I think. We have loved this system because although we are generally healthy people, we have had issues this year with our baby, and it's a huge relief to be able to just take him to the doctor anytime we feel we need to, and not just when it's dire. And, we love that we can use the funds from our HSA for any and all health related costs--dental, vision, chiropractic, massage, etc.

As I said, I have no idea if this type of set up is available for someone in your situation, but I'd highly recommend it if so. For what it's worth, our plan is Blue Cross Blue Shield, and it's through Lumenos. Good luck, I hope you find something that you can believe in and that will let you sleep at night knowing you're covered if something happens.

It looks like some of the above posters have some great suggestions on finding brokers and healthcare plan hopefully that provides you with some good leads. When I was in between coverage I used BCBS short term coverage for myself and my son. Sorry I dont know of any other options.

My only thought is making sure you are all on some sort of catastrophic plan. We had an emergency mdical situation and were at Emanual for 10 days. Once the billing came in I kept a spreadsheet on the costs out of morbid fascination. $116K for 10 days. It is mind boggling.

Good luck I hope you find something that works for you and your family.

My husband and I are both self employed and pay for our family's insurance ourselves. I found our plan through www.ehealthinsurance.com. It gives lots of options. If they cost too much, I'd consider just insuring your boys....it's usually much cheaper than adding adults. I'd caution against going without though.

I had a bike accident a few years ago and needed surgery and my brother-in-law had the same while uninsured. Tens of thousands in hospital bills makes me want to have insurance at all times.

I used my university alumni association's short-term health insurance for a 6-month stint once. High deductible but not bad per month. Good luck!

I agree with many of your experiences and comments. Everyone needs good healthcare, education, and respect.

We are looking to find a naturopathic plan for our small family, but as students, part-time employees and small business owners in start-up, our budget is limited.

Has anyone found a naturopathic family doctor that they would like to refer us to? Best of luck to Obama-Biden for making things happen, and in the meantime, what should we do to create fair and available healthcare for all, like in other countries of the world? Boycott doctor visits? Write health care insurance companies? Don't pay premiums until they become more like "minimums?"

I love the photo, I think it really sums up the feeling I get when I think about health insurance. It makes your brain swim.

Sadly, even if your income is low enough to qualify for OHP, they are not currently enrolling new adults in the program. The program is "closed" and only serves about 24,000 adults right now. (Kids are a different story - the income level is much higher for kids - 185% of the federal poverty level) and is open to new enrollment.

This does not help in the short term, but if you care about access to coverage, I encourage you to call your state legislators and tell them to support the recommendations of the Oregon Health Fund Board. (this group has been working on proposals for universal coverage in Oregon, and its ideas will be turned into legislation in the next legislative session in January)

Sarah,

We have Uzi on a BCBS plan that's really affordable and covers everything we need. Geo and I have high-deductible plans and we use an HSA. Until last year, we had Kaiser, and it was the pits. Now we spend much much less on healthcare, even though we pay out of pocket for lots of things. And the quality of care we receive now that we can go to smaller practitioners is incomparable.

The agent that helped us work everything out was:

Holly Worthington
Austin/Worthington & Associates
11501 SW Pacific Hwy. Ste. 100
Portland OR 97223
503-245-3231 Bus.
503-245-3684 Fax.
holly@austin-worthington.com

(I found her info on URBANMAMAS), and I *highly* recommend her. She really spent a lot of time helping me to understand the various options.

Good luck!

We are fortunately insured through my husbands work.
But a friend of mine is on FHIAPP(Not sure what that stands for). It is insurance on a sliding scale basis -- Your payments are based on your income. No pre-existing conditions,though.
Something to look into.

I am a firm believer that it's important to have health insurance. When I was 21 I was diagnosed with diabetes. Luckily, I was covered by health insurance. There was a short time when I wasn't (right after I got married and before I got a job). I tried to get insurance and I am UNINSURABLE meaning that without a job that provides insurance I can't get it. If you were to get a chronic condition, you would also be uninsurable. By keeping insurance at all times this will not happen to you. A family on our street just had their house foreclosed partially because they were buried in medical bills.

there is also OMIP, which is a state program separate from OHP designed to provide private insurance for folks who either can't do COBRA or have pre-existing conditions that disqualify them from other private insurers. it's not the cheapest or best plan, but not the most expensive either.

i feel for you -- i have been self-employed with pre-existing conditions for years, and paying the COBRA or relying on someone else's benefits is hard ... but it beats a pile o' medical bills. (i learned this first hand when i wound up hospitalized 4 times in 4 months right after i bought into COBRA ... the premiums were horrible but way, way less than what i would have paid out of pocket.)

Most independent health insurance plans (not through your employer) charge premiums according to age. Generally, the younger you are, the cheaper the insurance is. So even if you don't insure yourself, you could easily insure your kids. And you should.

Think about all the accidents that could happen. For instance, my husband ruptured his achilles' tendon a few weeks ago and required surgery. Skipping that surgery wasn't an option--he would be lame for life. But it will easily cost $15,000. If we didn't have insurance, our savings would be wiped out. Medical bills add up FAST.

Work with an insurance agent to find a plan you can afford, even if it just provides catastrophic coverage for if there's a serious accident or illness. Would your kids qualify for SCHIP? I don't know, but I'm sure an agent would. Isn't there insurance available to kids through Portland Public Schools? I've never paid attention to the flier that comes home at the beginning of the year, but again, I'm sure an agent knows the details.

And if a regular insurance company turns you down for health reasons (this happened to me because I have asthma), you are eligible for OMIP. OMIP is good coverage and not much more expensive than regular coverage. Please, please don't assume you can't afford insurance and please don't go without.

When I first moved to Oregon about 5 years ago, I had COBRA insurance for a year or so. When that was going to run out, I started looking around for individual plans. The individual health plan I ended up purchasing was from Pacific Source. I carried the Pacific Source plan for over 4 years, before my spouse recieved coverage through his new employer. I was happy with Pacific Source. They had a modest co-pay for basic visits and a reasonable deductible for other things. Plus the plan I chose had some prescription drug benefits. I was with Pacific Source for about 2 years before I got pregnant. I was really worried that when I got pregnant they wouldn't want me as a customer anymore. But everything was just fine. They covered my pregnancy and added my son on my policy as soon as he was born. I second others that have send "Please get insurance" Paying for premiums is much better than not having coverage... especially for your little ones.

This post actually scares me. My life is put in two categories. Pre-car accident and Post-car accident. Pre-car accident my family and I did try the "no insurance" plan for a few months. We couldn't afford the high COBRA premium and had no other health care coverage.

TWO MONTHS after my husband returned back to work, and we all were covered again, the car accident happened. I can not tell you how many times I have been relieved that the car accident did not happen two months prior. We have over a million dollars in medical bills for him alone. We have a fourth surgery coming up (I don't think I am even counting the second surgery in this estimate) I also have needed more medical benefits because of the stress caused by the accident. What would we have done? I am not even sure how we are going pay COBRA without him working in two months... We will figure it out somehow. There is no other option.

So here is my post-accident moral of the story. Do not go without health insurance. Review your car/life/disability insurance policies with a fine tooth comb. Pay the extra $2 a month it takes to get the extra million dollars worth of coverage.

We really need a national health care system. No one is invincible. Bad accidents happen to good people. Money is the least of my worries in this situation..butit compounds the stress. What if something else happened? To me, my husband or god forbid my two year old child?

I want to point out another important advantage of having even a high-deductible plan is that you pay the insurance company's negotiated rate for services rather than the full charge - which can be significantly higher. I am sure you have seen this on your EOB's from your current insurance - you would pay the allowed amount rather than the charges. We recently had a bill that, while applied to the deductible, was almost 1/2 of what it would have been if we had not had insurance.

Hey that's my son's doctor's office in the photo! Great suggestions posted here. I'll also be losing my job and benefits in December and my husband is self-employed. Our family's health benefits have always been covered through my work, but with the economy, the job situation is a bit bleak, so we've got to figure out a plan ASAP for health coverage. Does anyone know if there's a group plan for self-employed individuals to lower the costs? If so, please email me @ ccasama@yahoo.com. In the meantime, I'll definitely check out the other amazing resources posted. Thanks!

My husband and I are both self-employed, so we have to buy our own health insurance on the open market. We go through BCBS, and like someone mentioned, having 1 child or 4 children on the plan is the very same cost.

For us, it was cheaper for my husband to get a plan with him and the kids, and for me to get my own plan. We pay around $400 for our family of 4, and that includes all the normal stuff with a $1000 deductible for hubby/kids and $500 for me.

I was initially denied regular BCBS coverage due to a supposed pre-existing condition, and got on the OMIP plan. First off, I cannot recommend this enough! The coverage was fantastic!!! Better than what I have now. It was also cheaper, and covered more. I ended up not having the condition they thought I had (I was pregnant at the time, so could not be tested properly for it) but I probably should have just stayed on OMIP. It's a great program and we are lucky to have it here in Oregon.

My husband, while self-employed, has a client that is a large employer who he has considered working FT for. When we investigated their excellent Health Coverage, it was going to be around...you guessed it $400 for our family!! Sure, it would cover more and be better insurance, but out of pocket costs for us would have been the same.

I truly feel that going without it is a risk that really should be the very last resort! There are definitely economical plans out there, and especially for the kids, getting a plan for them through BCBS is under $100 per month. I don't think your kids should go without insurance...I have a 4 yr old boy and I know what can happen!!! Definitely get an agent and see what you can find. You might be surprised that it's more affordable than you thought. I know we were surprised when we got our plans!!!

Another recommendation for OMIP - my mother is on that plan, due to pre-existing conditions and alimony that is "too high" for her to be eligible for OHP. Her coverage is excellent, and there are several deductible options. Again, not as cheap as catastrophic, but a relief to have solid coverage knowing her health issues.

My husband and I are both self-employed like many of the other commenters. All I can say is, if you can at all in any way afford insurance, buy it buy it buy it! Don't gamble that it will remain little hundreds here and there. I got sick, completely unexpectedly, with something that will not go away for the rest of my life. I'm saving $2000 a month on the retail price of medication alone. I am so glad we bought insurance.

We have Kaiser, which is mostly because that's what I used to get when I worked for someone else. We pay more per month for insurance than we do for our mortgage. But I'm afraid that's what happens when you freelance. Ugh. As someone else mentioned, it's deductible.

My hubbie and I are both freelancers and I was in the same predicament when we had our bambino this year. After a TON of research, we signed on to Lifewise (www.lifewiseor.com) and are on their "Essentials" program. We pay about $250 a month for all 3 of us - benefits include a $25 co pay for most everything. The best part is you can choose whichever provider you'd like, which means we can go to our naturopath - yay! And no having to get "referrals" first from your doctor (i hate those!)

The only drawback - a $5,000 deductible for emergency hospital stays. So, basically, it's the "if god forbid we have an astronomical hospital bill, at least we're only stuck with 5 grand worth of it and don't have to file for bankruptcy " plan.

BTW - avoid Kaiser! They are awful. I know, firsthand.

I hope this helps. I love your blog! Keep up the great work, and congrats on going freelance!

This is why it's vital to understand the terms of the insurance before applying to it. You need to be sure that there's proper coverage.

You should consult a social worker to make an assessment for your situation. You could ask a referral for Cobra or the Oregon health plan. I'm not sure this is going to work but its worth a shot if you have low income.

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