Tuesday, August 12, 2008

Getting Individual Health Insurance: My Experience


You may or may not know that the freewheeling lifestyle as an hourly/PRN (rather than contracted part- or full-time nurse) I currently enjoy is possible in large part because I don't depend on my employer for health insurance. For the past year, I've had insurance through George Washington University, because I prepaid my policy at the beginning of last school year.

But while it's given me insurance in name, at least, I've still wound up paying out of pocket for a variety of things and it's particularly annoying because my primary care provider (PCP) is considered to be GW Student Health: meaning that in order to have a service covered, it needs to either be performed there, or I need a referral from there, which itself requires a face-to-face consultation (even for services that they flat-out don't provide, which is ridiculous). Getting into DC, and getting an appointment, to be seen for something thus becomes at least a four-hour process, and one which 9 times out of 10 I've concluded isn't actually worth it. Honestly, I think I would probably be willing to go without health insurance (something that scares the crap out of people, and rightfully so), but it's a requirement for nursing clinicals and so, perhaps luckily, I'm spared from making that momentous decision. However, my GW insurance expires on the 21st, Frontier doesn't offer insurance, and getting insurance through Matt's work would cost around $300 a month. So I set out to see what I could do on my own.

I was pleasantly surprised by what I found. Though I'm a healthy young person in general, I do have a past history of treatment for depression and stomach problems, and I was nervous that this would preclude eligibility or at least drive my premiums up. That didn't seem to be the case. I started my search on ehealthinsurance.com (there's also an ehealthinsurance.org, which I don't have experience with), which allows one to input several characteristics and choose among various providers. Like many search programs, the results initially returned are those sponsored by "featured providers," but you can click a radio button to "show all results" which will include smaller (and often cheaper) companies.

Three of the major ones I came to consider are Anthem, Humana, and United Healthcare. I ruled out the last one pretty early on, as they were the provider of my current policy and I wasn't impressed. Humana appealed to me because apparently they have a large philanthropic foundation, but their coverage ultimately seemed less comprehensive than Anthem's plans of comparable price, and since we already commit a portion of our budget to charity, it seemed higher insurance premiums would be a somewhat roundabout and questionable way of helping those in need.

So it came down to several Anthem plans with a variety of premiums, deductibles, and features. While some were as low as $60 a month, these plans often didn't cover anything toward office visits, lab tests, or prescriptions until a high deductible was met. Since I'm pretty much locked into an OB-GYN visit (~$100), a Pap smear (~$100), and 12 months worth of birth control (~$420 for generic without insurance) a year, at the very least, it seemed like it might behoove me to opt for a plan that gave some coverage for these items, not to mention a little more padding between me and possible medical/financial disaster. So, I opted for a plan (Anthem KeyCare with Enhanced Drug Benefits) that cost $108 a month which had a $2500 deductible (and out of pocket maximum), a $20-30 copay for various office visits, and a $15/40% copay for generic drugs. That way, I'm not shelling out much more than I would have if the above were my only out-of-pocket expenses for the year, and I'm considerably more well-insured in the case that any other problem were to arise.

Because I read less than favorable reviews of ehealthinsurance.com (including the fact that consumers were getting stuck in an endless volley of shirked responsibility between that company and the one which ultimately provided their insurance), I decided to take this quote right to the source and apply directly through the Anthem website. After completing an underwriting process of providing every detail of my medical history (that I could remember...), I was told that I would hear in 2-3 weeks whether my application had been accepted. The only unnerving factor about the application process was that you had to give a credit card number so they could charge the first month's premium if you were accepted. This doesn't leave room for backing out or changing your mind, and I worried that they would charge a higher amount than I had been quoted. But, I needed health insurance and this was the best deal I could find, so I went ahead and gave it.

Sure enough, in about two weeks I received an automated phone message from Anthem telling me to log into their website and that I would receive a welcome package in the mail within the week, which I did. My credit card was charged for exactly $108, and so far, all seems to be as promised.

Obviously I'm not too far into this process, but for anybody seeking individual health insurance, I'd recommend using a site like ehealthinsurance to compare your options, and then applying directly through the company of your choice. It worked well for me, and I was surprised to find cheaper and more comprehensive coverage than was offered through my place of work or Matt's.

Unfortunately, not everybody is so lucky...

1 comment:

Anonymous said...

Congratulations on getting covered. I actually work for eHealthInsurance.com so I was interested to see that you visited our site, even if you didn’t buy your plan through us. I’m aware of the reviews on Epinions but I would point out that most of the criticisms there are the result of people confusing eHealthInsurance with the actual insurance company whose plan they selected.

Working through eHealthInsurance is a lot like working through your local insurance agent down the street, except that we’re online and have a much bigger selection than any single agent. When you buy a plan through eHealthInsurance, you fill out the same application and pay the same price as if you bought it direct from the insurance company. But applications submitted through our site are often processed faster thanks to our eSignature technology.

In your case, the thing you miss out on by not buying through a licensed agent like eHealthInsurance is the ongoing support that we could provide. In our role as your agent we can be an advocate for you with the insurance company in case you have any disagreements over your benefits or how a claim was processed.

Amir M, licensed agent