# Educate me about health insurance, please **URL:** \ **Category:** In My Humble Opinion\ **Created:** [October 8, 2004, 7:59am UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171 "2004-10-08T07:59:38Z")\ **Posts on this page:** 13\ **Page:** 1
**Author:** ![SenorBeef](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senorbeef/32/2220_2.png) [@SenorBeef](https://boards.straightdope.com/u/SenorBeef)\ **Post date:** [October 8, 2004, 7:59am UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/1 "2004-10-08T07:59:38Z")
I’ve never had to have my own health insurance… until my (as a dependent) insurance expires next month. I don’t have a real job, I play poker. So I’ll need some sort of independent health insurance plan. What info I’ve found out about them thus far is slightly confusing, so I would appreciate if someone with experience could explain what I should look for in an insurance company. I don’t visit the doctor much, however, I may need to see a shrink/counselor/whatever now on a regular basis for a while. Most of the plans I’ve come across feature a $2500-$5000 yearly deductable, but that seems like a lot of money to pay out of pocket before your insurance kicks in. The thing is… I don’t really know. I have no idea if an emergency room visit for a sprained ankle costs $100 or $1000, so I don’t have an idea of how much my typical year incurs in medical costs. I suppose if I’m going to see a shrink regularly, I’ll be paying up to my deductable every year, so it might be smarter to pay a larger premium to go with a $500ish deductable. Do shrink visits count as the “office visits” I see on some of these plans? Some plans have a fixed cost per office visit, others have a normal copay, etc… does that just refer to your primary/general care doctor, or what? Aside from the possible shrink visits, I only see a doctor maybe 2-3 times a year, don’t have any real medical conditions (except being fat, which I guess I may have to pay a premium for), so I’m a bit clueless as to what I need in a plan. I guess something with a $500-$1500 deductable, 80/20 copay, and $100 a month premium seems reasonable for what I want… or does it? I’m not really sure. Are there any companies I should stay clear of? I notice I have the choice of indemnity, PPO, and HMO. What would be most suitable for me? Thanks for any advice. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [October 8, 2004, 10:25am UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/2 "2004-10-08T10:25:45Z")
> [@SenorBeef](#): > > I guess something with a $500-$1500 deductable, 80/20 copay, and $100 a month premium seems reasonable for what I want… or does it? If you live in the United States, this is not possible. You _might_ get that coverage as an individual with known health problems (you’re overweight and see a “shrink”, right?) for $1,000 a month. > [@](#): > > a $2500-$5000 yearly deductable, but that seems like a lot of money to pay out of pocket before your insurance kicks in. It is. > [@](#): > > The thing is… I don’t really know. I have no idea if an emergency room visit for a sprained ankle costs $100 or $1000 Closer to $1,000 than $100 > [@](#): > > I suppose if I’m going to see a shrink regularly, I’ll be paying up to my deductable every year, so it might be smarter to pay a larger premium to go with a $500ish deductable. Do shrink visits count as the “office visits” I see on some of these plans? In general, psycological needs have poor coverage. You might even wind up paying more in premiums than you get out of the coverage for psych needs - medical insurance tends to focus on the physical. You _might_ be better off paying out of pocket for the head doctor and negotiating a sliding fee scale with him/her rather than going through insurance (which will also tend to place sharp limits on number of visits, services provided, and in some cases pry into your treatment). > [@](#): > > Some plans have a fixed cost per office visit, others have a normal copay, etc… does that just refer to your primary/general care doctor, or what? Depends on the policy. _Be sure_ to read the fine print. > [@](#): > > Are there any companies I should stay clear of? I notice I have the choice of indemnity, PPO, and HMO. What would be most suitable for me? Thanks for any advice. HMO’s are generally cheaper (though not as much as they used to be) but with more restrictions. Indemity is least restrictive, and most expensive. PPO’s are in between, and I think the most common insurance plan these days. Problem is, as an individual of less than perfect physical and mental health, you will be facing high rates. Health insurance is _expensive_. ---
**Author:** ![Inigo\_Montoya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inigo_montoya/32/124_2.png) [@Inigo\_Montoya](https://boards.straightdope.com/u/Inigo_Montoya)\ **Post date:** [October 8, 2004, 11:58am UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/3 "2004-10-08T11:58:34Z")
Here’s [Insurance according to **Inigo**.](http://boards.straightdope.com/sdmb/showthread.php?t=277553) And yeah, as the Scotsmen say, “Brace yeself Bridgett!” It’s gonna cost you a penny or two. ---
**Author:** ![GingerOfTheNorth](https://avatars.discourse-cdn.com/v4/letter/g/cdc98d/32.png) [@GingerOfTheNorth](https://boards.straightdope.com/u/GingerOfTheNorth)\ **Post date:** [October 8, 2004, 2:10pm UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/4 "2004-10-08T14:10:44Z")
My husband sells health insurance to self-employed persons such as yourself. He may be able to help you out with any questions you have. However, unless you live in Maryland, he will have to direct you to a local person. He’ll be home this evening, and I’ll direct him to this thread. ---
**Author:** ![akennett](https://avatars.discourse-cdn.com/v4/letter/a/ee59a6/32.png) [@akennett](https://boards.straightdope.com/u/akennett)\ **Post date:** [October 8, 2004, 2:23pm UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/5 "2004-10-08T14:23:02Z")
Another consideration may be any societies, groups, or organizations you belong to. Some such entities might offer their members a group rate plan from some insurance companies. This would almost certainly be cheaper than getting something on your own, so, if you belong to anything, check them out. ---
**Author:** ![SenorBeef](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senorbeef/32/2220_2.png) [@SenorBeef](https://boards.straightdope.com/u/SenorBeef)\ **Post date:** [October 8, 2004, 8:21pm UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/6 "2004-10-08T20:21:55Z")
> [@Broomstick](#): > > If you live in the United States, this is not possible. You _might_ get that coverage as an individual with known health problems (you’re overweight and see a “shrink”, right?) for $1,000 a month. I was browsing on [ehealthinsurance.com](http://ehealthinsurance.com) and something in that range seemed viable from the little questionaire they had me fill out. I don’t see a psychologist currently - I decided to hold off on that specifically because it would be considered a pre-existing medical condition and would make my insurance situation more difficult. Does being overweight increase premiums dramatically? I don’t have any chronic health problems that have developed from being fat. > [@](#): > > In general, psycological needs have poor coverage. You might even wind up paying more in premiums than you get out of the coverage for psych needs - medical insurance tends to focus on the physical. You _might_ be better off paying out of pocket for the head doctor and negotiating a sliding fee scale with him/her rather than going through insurance (which will also tend to place sharp limits on number of visits, services provided, and in some cases pry into your treatment). I’m guessing if I pay out of pocket I’m looking at fees well in excess of $50 an hour, which is pretty steep. Hmm. ---
**Author:** ![Weirddave](https://avatars.discourse-cdn.com/v4/letter/w/919ad9/32.png) [@Weirddave](https://boards.straightdope.com/u/Weirddave)\ **Post date:** [October 8, 2004, 10:36pm UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/7 "2004-10-08T22:36:12Z")
There is a lot of misinformation about HI programs out there, particularly in Inigo’s post in the other thread. Almost always, your “max out of pocket” is a pipe dream, a fantasy, and I’ll tell you why: It’s based upon “covered expenses”. What’s covered, you ask? Generally whatever the insurance company feels like covering. I see people who have had to pay 5, 10, even 50K out of pocket for a plan with a “$2000 out-of-pocket max”. E-healthinsurance is another misleading place to buy HI coverage. It’s got tons of companies who sell on premium price and nothing else. Usually they are the ones that wind up sticking you as above. There is a reason they are so cheep, you can’t buy a Mercedes for the price of a Yugo, you know. You need someone to individually design a program for your specific needs. Email me your phone number and I’ll be glad to call and spend some time with you doing just that. weirddave0 at hotmail dot com. > [@broomstick](#): > > If you live in the United States, this is not possible. You might get that coverage as an individual with known health problems (you’re overweight and see a “shrink”, right?) for $1,000 a month. Dude, where the hell do you live? Baring rate ups because of health problems, full coverage for a smoker in his 60s (the most expensive catagory I can think of off the top of my head) is only about half that. For (I am assuming from his post, saying he just went off dependent coverage) a young male you’re talking $150-$200/month tops, and that’s including stuff like dental, vision and disability. Good solid indemnity coverage too. ---
**Author:** ![Kent\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kent_clark/32/105_2.png) [@Kent\_Clark](https://boards.straightdope.com/u/Kent_Clark)\ **Post date:** [October 9, 2004, 3:41am UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/8 "2004-10-09T03:41:10Z")
> [@SenorBeef](#): > > I don’t see a psychologist currently . . . > > I’m guessing if I pay out of pocket I’m looking at fees well in excess of $50 an hour, which is pretty steep. Hmm. Unless you find a therapist who’s willing to negotiate, the standard fee is about $85 and up here in the Midwest. If you’re currently a dependent on a family plan, you might want to contact that company and see if they might have a program where they switch you to your own coverage at a better rate than a new company. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [October 9, 2004, 10:59am UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/9 "2004-10-09T10:59:01Z")
> [@Weirddave](#): > > Dude, where the hell do you live? Baring rate ups because of health problems, full coverage for a smoker in his 60s (the most expensive catagory I can think of off the top of my head) is only about half that. For (I am assuming from his post, saying he just went off dependent coverage) a young male you’re talking $150-$200/month tops, and that’s including stuff like dental, vision and disability. Good solid indemnity coverage too. Where do I live? Check the location box. Anyhow, I was assuming he was already seeing the shrink, which can up your rates. Yeah, IF he’s young, and is JUST overweight, he MIGHT get a lower rate… but not the $100 to $150 a month he wants. And, like I said, you have to read the fine print. See what they exclude as well as include. ---
**Author:** ![Barbarian](https://avatars.discourse-cdn.com/v4/letter/b/e19adc/32.png) [@Barbarian](https://boards.straightdope.com/u/Barbarian)\ **Post date:** [October 10, 2004, 1:12pm UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/10 "2004-10-10T13:12:02Z")
Reading this thread makes me so glad I get to move back to Canada in a couple years, where I will never have to worry about health coverage again! To be honest, I’m constantly stunned every time I see just how much my doctor or dentist tries to charge my insurance company for every procedure-- and how many frivolous procedures they attempt to sneak in. ---
**Author:** ![Canadjun](https://avatars.discourse-cdn.com/v4/letter/c/76d3ee/32.png) [@Canadjun](https://boards.straightdope.com/u/Canadjun)\ **Post date:** [October 10, 2004, 11:16pm UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/11 "2004-10-10T23:16:24Z")
> [@Barbarian](#): > > Reading this thread makes me so glad I get to move back to Canada in a couple years, where I will never have to worry about health coverage again! To be honest, I’m constantly stunned every time I see just how much my doctor or **dentist** tries to charge my insurance company for every procedure-- and how many frivolous procedures they attempt to sneak in. Dentistry is not covered under provincial health plans. ---
**Author:** ![astro](https://avatars.discourse-cdn.com/v4/letter/a/9dc877/32.png) [@astro](https://boards.straightdope.com/u/astro)\ **Post date:** [October 11, 2004, 12:10am UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/12 "2004-10-11T00:10:12Z")
> [@GingerOfTheNorth](#): > > My husband sells health insurance to self-employed persons such as yourself. He may be able to help you out with any questions you have. However, unless you live in Maryland, he will have to direct you to a local person. He’ll be home this evening, and I’ll direct him to this thread. I’m looking to possibly change my plan as the cost of the Golden Rule plan I have has racheted up hugely even though I’ve never some close to touching the $ 2500 deductible. I’m an independent contractor (real estate agent) 47 YO, non-smoker, no health issues in Maryland. Does your husband give quotes? ---
**Author:** ![GingerOfTheNorth](https://avatars.discourse-cdn.com/v4/letter/g/cdc98d/32.png) [@GingerOfTheNorth](https://boards.straightdope.com/u/GingerOfTheNorth)\ **Post date:** [October 11, 2004, 12:13am UTC](https://boards.straightdope.com/t/educate-me-about-health-insurance-please/268171/13 "2004-10-11T00:13:06Z")
> [@astro](#): > > I’m looking to possibly change my plan as the cost of the Golden Rule plan I have has racheted up hugely even though I’ve never some close to touching the $ 2500 deductible. I’m an independent contractor (real estate agent) 47 YO, non-smoker, no health issues in Maryland. Does your husband give quotes? Let me make very clear that Dave is not soliciting business on the board. If you would like to talk to him about it, please email him or me at the email address listed in our profiles.