Health Insurance

[Horsepower]

Checking out alternative health insurance options. Has anyone heard of or had experience with MegaLife Insurance? Any other suggestions for high deductible, major medical insurance coverage?

[nodak3]

Contact your house or auto insurance co. Some of them offer this.

[Pansies4me]

My husband and I explored MegaLife through the National Association of the Self-Employed. The thing that jumped out at us was how many things were not covered for the first 6-24 months you are enrolled (pregnancy and delivery, for example did not kick in for a year or two). We found the coverage to not be very thorough and by the time we would have added the riders we wanted/needed, we were just as well to stay with the (more expensive) HMO we currently have (which we really do like except for the premiums!).

I don't have any ideas re: only major medical, but do check things out carefully re: how soon you are fully covered in all areas.

Sallie

[BackwoodsIdaho]

Stay away from MegaLife. The Wall Street Journal did an article a month or two ago about a number of people that bought policies from them and then found themselves without coverage for things that should have been covered. The company takes the position that it won't pay and if the insured doesn't like it, then you will have to take them to court. In the meantime, if you have cancer or need a bypass operation, you die waiting to go to court.

I would recommend an HSA policy thru a non-profit like Blue Cross or Blue Shield. We have one thru BC of Idaho and, while the deductible is high ($6000 per year for the family) they will be there if we have something life threatening and you can put the deductible into an HSA account tax free each year. If you don't use the money, then you can have it for retirement when you hit your later years just like an IRA or 401K

jim

[John_in_Houston]

BackwoodsIdaho - can you elaborate on what an HSA account is?

I've heard the MegaLife insurance ads on the radio - my first thought was that anything with a cheesy name like 'MegaLife' is probably scam-ish.

[amelia]

Search for a thread started about 3 months ago regarding health savings accounts.

[MichelleB]

I had MegaLife for about a year, and have since switched to an Oregon-specific product that is much less expensive, more user-friendly, and has more benefits. I'd avoid it.

[kz]

Go to HSAinsider.com. They cover everything.

Also try ehealthinsurance.com.

[syringaweb]

We also had Mega through NASE. Note the "had", enough said.

We now have Anthem (Blue Cross), and are also getting ready to switch to a medical savings account (high deductible) insurance. If you're fairly young and healthy, it really does seem to be the way to go.

Michelle

[amelia]

I'm seriously looking at an health savings account for myself. My choice is to shell out $500 per month or so for a traditional plan, or pay about 1/3 of that for a high-deductible policy coupled with an HSA. I checked with one of the premier health insurance providers here in Washington to get some quotes, and here is what I found:

$1,250 deductible policy: $232 per month
$1,700 deductible policy: $169 per month
$2,500 deductible policy: $139 per month

Here's how it works: Let's say that I opt for the $2,500 deductible policy for $139 per month. I would take out a special savings account with an HSA qualified bank--something analogous to an IRA--and fund it with any amount I chose up to $2,500. If I incurred a run-of-the-mill medical expense, I would take my HSA "credit card" to the provider (or pharmacy, or whatever) and the charge would be automatically debited from my account. This would continue throughout the year up until such time as I have incurred a total of $2,500 in medical expenses. At that point, the high-deductible policy would take over and pay 80 percent of everything. When I hit the stoploss amount of $3,400, it would pay 100 percent.

The way I see it, this is a pretty reasonable deal for a basically healthy person. Assuming that you were to go with a traditional policy at a cost of about $500 per month, you'd be CERTAIN to pay a total of $6,000 out of pocket just in premiums--not to mention the usual 20 percent co-insurance. On the other hand, a high-deductible policy coupled with an HSA would cost you a total of only $1,680 per year in premiums, so it's going to take $4,300 a year in medical expenses for you to be any WORSE off with an HSA. Suppose, however, that because you're basically healthy you have medical expenses of no more than $500 in a particular year. In that case, you'd have saved $3,800. With that kind of savings, I figure you can afford to have a serious illness now and then.

Looking at the very worst case scenario, you're never going to be out of pocket more than $3,400 per year, because that's the stoploss amount. I suppose that you could have a horrible accident in December of Year One and need ongoing treatment in January of Year Two and thus incur a total out-of-pocket of $6,800 in a matter of a couple of months, but that's still not all that much more than you'd be paying for the traditional plan.

The intriguing thing about HSAs is that the contributions (which can be made in any amount up to a yearly maximum equivalent to the plan deductible) are entirely tax deductible--and this is true whether or not you itemize. Whatever you don't use for health-related expenses simply rolls over and accumulates from year to year. The funds are yours in every sense of the word--there's even a beneficiary named on the account, just as in the case of a life insurance policy. The funds can be used for non-medical purposes, but, just as in the case of an IRA, there is a substantial penalty unless you become disabled or hit age 65. Also interesting is the fact that HSAs can be used for a far broader array of medical expenses than a traditional insurance policy would cover. For example, over-the-counter drugs, such as cold medicine, qualify, as do premiums for long-term care insurance. Also, individuals with HSAs are entitled to the same negotiated rates that they would receive if they had a traditional policy.

Hope that helps.

Disclaimer: I'm still figuring all this out, so please do your own research and verify all aspects for yourself.

[BackwoodsIdaho]

Originally Posted by John_in_Houston

BackwoodsIdaho - can you elaborate on what an HSA account is?

I've heard the MegaLife insurance ads on the radio - my first thought was that anything with a cheesy name like 'MegaLife' is probably scam-ish.

Looks like others pretty well covered it.

[shelbynteg]

Here's a company I'm looking at, they offer coverage in Texas, but I don't know where else.

Unicare...

I know they don't have any mental health coverage, but I do like that they offer 4 doctors visits per year at $30 each, then your deductible begins.

Anyone with experience with them?

[John_in_Houston]

Originally Posted by BackwoodsIdaho

Looks like others pretty well covered it.

Thanks, all.

Anyone have any experience with 'health insurers of last resort' ? My wife has had a heart attack (at 37 years old, no less) and I think we are going to have some problems getting coverage for her.

[Ana Bluebird]

Since we are self-employed, no groups, we have always had to try to buy our own health insurance. I've had terrible luck finding anything that is worth the money, pay in for years, then find out when I make a claim that they don't pay what they said they would. Well, just sue them, right, sure, if you can afford to. We currently have a high deductible with BlueCross/Blue Shield, doesn't pay much on anything but has contracts with most hospitals and doctors so you get a discount on things. For my husband and I we pay $500 a month, but then we are in our late 50's, and thank God still healthy. I wish we had some help with our medicines---so expensive and going to get worse.

[Cygnet]

For medication, you can at least get a discount with:

https://rxsavingsplus.advancerx.com/...Site/index.jsp

Card's free.

Leva

Originally Posted by Ana Bluebird

Since we are self-employed, no groups, we have always had to try to buy our own health insurance. I've had terrible luck finding anything that is worth the money, pay in for years, then find out when I make a claim that they don't pay what they said they would. Well, just sue them, right, sure, if you can afford to. We currently have a high deductible with BlueCross/Blue Shield, doesn't pay much on anything but has contracts with most hospitals and doctors so you get a discount on things. For my husband and I we pay $500 a month, but then we are in our late 50's, and thank God still healthy. I wish we had some help with our medicines---so expensive and going to get worse.

[redrocket222]

STAY AWAY!! MegaLife screwed my uncle on his coverage. He had to undergo an angioplasty in his knee, and they denied him coverage. (Certainly not for a lack of premiums, he was paying through the frickin' nose.) He has tried taking action out of court, but to no avail. He's still waiting for his court date today, and is overwhelmed by the aftermath of his surgical bills.

What I've found to be a good alternative to Insurance (AKA, getting screwed around) is a discount benefits plan called Med Express. The monthly fees are very affordable, and they cover all kinds of procedures that large insurances won't even touch. They have a website www.medexpressbenefits.com if you want to check them out.

[melinda]

Originally Posted by shelbynteg

Here's a company I'm looking at, they offer coverage in Texas, but I don't know where else.

Unicare...

I know they don't have any mental health coverage, but I do like that they offer 4 doctors visits per year at $30 each, then your deductible begins.

Anyone with experience with them?

I had Unicare under a small employer account for several years (only 2 employees covered, out of 4 total) and never had any problems. One of us - the other of the 2 - got breast cancer, Stage II, and ran up a heck of a bill. It is hard with ANY company to keep all that straight, but they do have a patient's advocate that you can use to help out. Our premiums did not go through the roof after this, either. I think Texas has a good insurance board, though, that helps keep insurance companies from messing with you too much. My pal will probably never be able to get any other insurance company, either - but she's still covered (I'm long gone!).

It helps to also have a good insurance agent, if you can find one. They will often help with contacting the company when you have questions. Insurance is the pits, ain't it?

I second the einsurance.com idea - my DH and I have a reasonable, high deductible policy we found through them, with a A rated company. I believe that policy now qualifies for HSA.