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I worked for the federal government before I quit tp raise my boys and my DH is self-employed.  I did COBRA for 18 months with my federal plan and then went to self-insured.  We have paid A LOT for it over the years, but we are grandfathered in to our plan post Affordable Care Act (thank goodness) and still have great coverage.

When we looked to change plans a few years ago, I searched the marketplace and called all our doctors to see if they participated with the plans we were interested in.  None of them were accepting the marketplace plans and we weren't willing to switch our doctors.  Things may have changed in the past few years though.

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16 minutes ago, desertflower said:

When we were self-employed a few years back, we joined Samaritan Ministries.  I believe one has to be a Christian to join though. 

Just to clarify for those not familiar, Samaritan Ministries is not health insurance but rather something known as healthcare sharing. 

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Posted (edited)
53 minutes ago, klmama said:

How do self-employed people buy health insurance, other than going through the federal marketplace?   

It varies by state

 

Some of the major vendors sell policies on the  individual market.

 

ETA. Cobra is one of the most expensive options.  There are usually others.

Edited by gardenmom5
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1 hour ago, klmama said:

How do self-employed people buy health insurance, other than going through the federal marketplace?   

Why don't you want to go through the federal marketplace? We used it for the first time this year and it is very user friendly. We were able to find an affordable plan that participated with our doctors. And premiums were just reduced as part of the American Rescue Plan.

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We had insurance through BCBS for the last 15 years, directly. Our premium increased each year, until finally we couldn't afford it. We switched to the marketplace this year. Waaaay better coverage at an 8th of what we were paying. Crazy. 

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30 minutes ago, katilac said:

Just to clarify for those not familiar, Samaritan Ministries is not health insurance but rather something known as healthcare sharing. 

Yeah, that's right. I had forgotten about that. Well, it was what we needed. I was paying $1200 /month for bcbs and $400 / month for samaritan ministries. I guess it just depends on one's needs. 

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Our friends and adult son all use the marketplace and have great, affordable plans. I’ve been impressed with their care, though I’d previously been very skeptical.

Years and years ago, before the marketplace existed, I was self-employed and it was hard to find insurance that was affordable.  I joined an artist’s guild for the sole purpose of being able to get in on their insurance plans.  The coverage was sketchy, and covered no Rx meds at all.  But it was better than nothing.  After DH had insurance through his company, I keep it as secondary until the rates skyrocketed.  They started increasing 400-500% every six months.  Crazy expensive for not much coverage, so I dropped it.  But something like that might still be out there.

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48 minutes ago, alisoncooks said:

We had insurance through BCBS for the last 15 years, directly. Our premium increased each year, until finally we couldn't afford it. We switched to the marketplace this year. Waaaay better coverage at an 8th of what we were paying. Crazy. 

Was it still BCBS or a different company?

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Posted (edited)

Adding that federal subsidies for medical insurance have increased with the recent federal Covid legislation.

ETA:  My understanding is that each COUNTY (much less each State) has unique plans and costs.
But BCBS is included in the federal medical insurance companies.
There are just a variety of plans from a variety of insurance companies.

Edited by Beth S
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COSE

Also, there are "third party administrators" of self-funded plans that will work with very small employers.

You can also create an individual Health Savings Account.

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10 hours ago, gardenmom5 said:

ETA. Cobra is one of the most expensive options.  There are usually others.

This is something that's repeated so often I think it's universally assumed to be true. But for us COBRA was significantly less expensive than going through the marketplace, and it was fabulous insurance. It really is an individual thing. I suspect many people are doing themselves a disservice if they don't at least check it out.

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Posted (edited)
2 hours ago, Pawz4me said:

This is something that's repeated so often I think it's universally assumed to be true. But for us COBRA was significantly less expensive than going through the marketplace, and it was fabulous insurance. It really is an individual thing. I suspect many people are doing themselves a disservice if they don't at least check it out.

My dh sells health insurance, he represents multiple vendors who offer plans on the individual market in our state.  In his experience, cobra is often one of the most expensive forms of health insurance. a "decent deal" - is the exception.

Edited by gardenmom5
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Posted (edited)
8 minutes ago, gardenmom5 said:

My dh sells health insurance, he represents multiple vendors who offer plans on the individual market in our state.  In his experience, cobra is often one of the most expensive forms of health insurance. a "decent deal" - is the exception.

"Our state" are the key words there. That does matter quite a lot, given that insurance is regulated at the state level and what marketplace plans are offered--and what they cost--varies quite a lot from state to state.

Edited by Pawz4me
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Just now, Pawz4me said:

"Our state" are the key words there. That does matter quite a lot, given that insurance is regulated at the state level and what marketplace plans are offered--and what they cost--varies quite a lot from state to state.

and some states (mine is better than average) - have super super sucky choices on the individual market.  dh has to be aware of those because he has clients who are back and forth with other states (and even other countries.)

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4 hours ago, Pawz4me said:

This is something that's repeated so often I think it's universally assumed to be true. But for us COBRA was significantly less expensive than going through the marketplace, and it was fabulous insurance. It really is an individual thing. I suspect many people are doing themselves a disservice if they don't at least check it out.

Doesn't COBRA only apply when a person previously insured on any employer-plan has lost eligibility within the past 60 days?  Under COBRA the person remains on the employer sponsored plan for up to 18 months by paying both the employee and employer portions of the premium.  

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2 minutes ago, Sherry in OH said:

Doesn't COBRA only apply when a person previously insured on any employer-plan has lost eligibility within the past 60 days?  Under COBRA the person remains on the employer sponsored plan for up to 18 months by paying both the employee and employer portions of the premium.  

There are certain eligibility rules, but I'd be afraid to offer specifics on those now. It's been awhile, so I've forgotten a lot. You can stay on it for up to 29 months in certain circumstances. When DH left his job due to disability--which is one of the circumstances that allows one to keep it longer than 18 months (and I think it may be the only circumstance under which one can keep it that long)--we kept the COBRA coverage for me for the entire 29 months. So I had it even after he transitioned to Medicare. It was a MUCH better deal for my coverage than anything we could get through the marketplace. There was nothing anywhere close in terms of cost + coverage.

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A clarification about BCBS because I think many people are confused. There is no "BCBS." There are individual insurance companies nationwide with a franchise to offer a plan in that market through the Blue Cross Blue Shield Association. Some states have more than one company with a franchise, e.g. California has Blue Cross of California (Anthem) and Blue Shield of California (independent). At one time, there were 6 different blues companies in PA but I think some of them consolidated a few years ago. 

About 25 of the states have a blues plan that is owned by Anthem Wellpoint (Indiana, Ohio, Wisconsin, Kentucky, Virginia, Georgia...etc). Then there are regional companies that own blues plans in multiple states, e.g. Regence (Cambia) which operates in 4 western states. HCSC owns blues plans in Illinois, Texas, Oklahoma, New Mexico, and Wyoming. Then there are independents like Horizon which is in New Jersey or BCBS North Carolina. 

Most plans offered through a blues plan have the blue suitcase which allows you to access care outside of your plan's (called the "home" plan) service area by accessing the "host" plan's network. If you have a BCBS plan, look for the blue suitcase logo on your card. This is called "blue card." 

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