Private Health insurance

lovebirds1111 · 05-07-2006, 08:02 PM

Hi everyone..

I was wondering if anyone has private health insurance here.

I get health insurance through my job but Im hoping to be a sahm soon. I will need to purchase some private health insurance

Can anyone recommend a company and tell me what its gonna cost me?

TIA

PaintedDaisy · 05-07-2006, 08:26 PM

I think any of the "biggies" would be okay. Usually when someone gripes about their insurance company, it's because of limitations of their plan, not the insurance company themselves (though not always).

So I'd say the biggest factor would be the plan type and the associated cost. I'd personaly go with the one that gave me the biggest bang for my buck, provided they aren't some little gonna-go-out-of-business-tomorrow-type shop. The cost will be dependent on the plan you choose, but typically is much, much higher than what you will pay for group insurance (because your company also pays a large chunk for you).

When I was looking at it last year, it was going to cost $600/month for just me and DD. If I increased the deductable to $1000 for DD and made my coverage catastrophic only, it was reduced some. That can be an option for you, but that means you'll typically be responsible for paying the full (but negotiated rate) for doctor's visits. Fortunately, they were willing to cover me despite having PCOS -- some ladies just aren't so lucky, even with a rider, so that's something you need to find out about.

I completely understand the predicament you're in. I want to be a SAHM mom too, but the insurance thing is what's getting us since I carry it for the family. We can't afford to both lose my income AND pay astronomical rates for insurance. . .one or the other but not both. Sigh. . .

packerfan · 05-08-2006, 02:50 AM

I have private health insurance since DH and I are both self-employed.

Things may vary by state but I was denied health coverage by every company I applied to because I was diagnosed w/ PCOS. I'm a thin cyster and on no meds for PCOS, never a surgery, nothing except met and clomid when TTC and I've been denied---UGGH!

Humana and BCBS were the "Big" companies I applied to. If you are denied by one, you'll be denied by them all most likely.

I'd certainly apply before dropping any current coverage or changing jobs.

This whole subject makes me mad, I wish you better luck!

~*Butterflygrl*~ · 05-08-2006, 05:24 AM

My friend who also happens to have PCOS has been looking for private insurance forever! Her dh is also self employed. They were denied every where they went. They have still found nothing to this day.

momspence · 05-08-2006, 06:36 AM

i recently checked out http://www.oneshopinsurance.com they have a couple of insurance companies here. but i wasn't able to check on whether they'll approve my application or not. hoping to find one too. goodluck to us

mystik817 · 09-27-2006, 04:38 AM

I had a good plan with Blue Cross Blue Shield that cost about 135 month, but I was going to docs all the time for OBGYN and Dermatology plus birth control and ance meds, it was well worth it. Good luck!

xShellyx · 09-27-2006, 05:23 AM

I also have a private plan through Regence Blue Cross Blue Shield. I have a 500 deductible per year and the plan covers myself and my two kids (medical, vision and dental) for 280 a month. I feel VERY fortunate to have this plan and for such a reasonable amount. It only covers 80% of my OB and hospital stay, but after so many cysters being turned down I still feel so lucky to have this plan. My ped. appts and immunizations are only a 20 copay. I know each state is different, but I'd check them out! HTH

julie007 · 09-27-2006, 10:45 AM

Quote:

Originally Posted by packerfan

I have private health insurance since DH and I are both self-employed.

Things may vary by state but I was denied health coverage by every company I applied to because I was diagnosed w/ PCOS. I'm a thin cyster and on no meds for PCOS, never a surgery, nothing except met and clomid when TTC and I've been denied---UGGH!

Humana and BCBS were the "Big" companies I applied to. If you are denied by one, you'll be denied by them all most likely.

I'd certainly apply before dropping any current coverage or changing jobs.

This whole subject makes me mad, I wish you better luck!

I am waiting on my application to be processed right now thru BCBS FL. They told me 4-5 weeks is the norm! that is crazy. Plus they took two months of premimums out of my bank account already. And I applied for the PPO for our family which is $440 a month. So...they have taken $880 from me and are going to take 4-5 weeks to tell me if they will cover me.

How did they find out that you had PCOS?

packerfan · 09-27-2006, 04:40 PM

A diagnosis code that was put on the insurance billing for my u/s with one of the kids I believe. It also could have been the blood test done to check FSH/LH when I actually was diagnosed.

I had "conveniently" forgotten to list it on my application, but when the denial came back and I quote "The reason for this action (denial of coverage) was history of polycystic ovarian syndrome.....If a rider excludes a specific family member from the policy, they would not be covered for ANY condition under your Personal Choice Plan".

Now the BCBS private plans in WI only provide a joke of a maternity coverage (you pay an extra $100/month) they cover up to $2,000 max and you have to take it from day 1 of the policy, no adding it later. Therefore you pay the full amount basically unless you get PG and have the baby within 12 months of taking out the policy. I also think there was a separate "deductible" just for maternity.

My state policy includes maternity at no extra cost and covers everything after I pay my deductible and co pay.

packerfan · 09-27-2006, 04:46 PM

Oh, the important part I forgot is I had BCBS insurance a few years ago, then DH had a job that offered insurance, I took it and after Ben was born DH quit the job and we were both back to being self-employed. So I applied with BCBS again, so they did have my history, plus a little grudge since they got stuck with my hospital bills and DS1's NICU bills (over $50,000) and delivery charges even though I didn't have maternity coverage with my previous policy. Premature labor is considered a medical condition and didn't fall into standard maternity care--HAHA! I used to feel bad since we had only paid in $1500 of premiums on that policy and they got stuck with a whopper bill, now I don't feel too sorry for them. (can you tell I'm a little bitter about this denial of insurance???)

julie007 · 09-27-2006, 05:56 PM

Well I did call them today and they covered us. I have had BCBS in the past so they must not have had any flags. We took the best PPO plan they had it is $440 a month for family. No deduct to satisfy before anything just pay the co-pay and with the PPO can go to any doc with no referal. The maternity is a 50/50 thing to have the HMO maternity it was and extra $400 on top of the regular payment! So they said you might not use it and the difference in what you would be paying monthly is about what you will be paying if you need it.

~Traci~ · 09-27-2006, 07:20 PM

You really have to be careful w/ insurance. All insurance companies (even if it's a national company) follow state laws (except if you work for the feds). Here in TX, the health insurance laws completely stink! We couldn't get an individual/family policy that covered maternity & the policies that we could get were VERY expensive. For just me, I was paying $700/month (it ranged anywhere between $600-$800/month but changed about every 6 months).

DH got a job & now we're all on insurance (well DH & me for now, Aimee will be added when she gets home) & it costs less than we used to pay for just me (same exact company).

You also need to read the fine print b/c we were going to get insurance from one company until we read that they would cover up to like $1500/year & then you were responsible for the rest which is completely crazy!

I too have an issue w/ insurance companies & stupid insurance laws, can you tell?

Can you get insurance through your DH's employer? It may be cheaper & less hassle in the end.

Traci

jennynd · 09-27-2006, 07:52 PM

I tried to get a private health plan but was denied b/c of med conditions (hadn't even been dx'd with PCOS yet!) so I wound up on our state BCBS plan which is actually pretty good & affordable, although I despise the company!!! In our state you can't be flat out denied (they have to offer you something else ie. state plan, or they can just charge insane amounts) so check out your state laws & plans first. Also, get health insurance BEFORE you drop the old insurance b/c usually then you can avoid being denied due to preexisting conditions & avoid waiting periods for coverage... something I learned the hard way! You really just have to shop around. I wanted to switch off this plan cuz I hate BCBS but when I went to another provider they said $75 per mo without maternity, $450 with!!! WTH! Way to punish me for being a woman! Sorry... this is turning into a rant.

My biggest advice is to get insurance before the old one is void & make sure you know exactly what will be covered before you commit to a plan. Good luck!

IFBPreachersWife · 09-27-2006, 07:55 PM

I have Anthem BC/BS of KY. I pay $275/month and it's an 80/20 plan for labs, hospitalization, etc. $25 copay for office visits $15/$30 prescription and of course, no infertility coverage. You can go to the BC/BS website and get rates and apply. HTH!