Getting Health Insurance after Job Loss

Archived Q&A and reviews ▼

Archived Q&A and Reviews

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Starting out on his own - we'll need health insurance

May 2005

My spouse is about to start out on his own career track, leaving his job & our health insurance behind. We need to find a new insurance plan for 2 adults and 2 kids. There may be a pregnancy in my future, so I'd like to find a plan with excellent prenatal coverage. I don't want to change doctors, so I think I want a PPO. Does anyone know where I should look to find a new plan? I checked the website but didn't find any recommendations. Anon.

You might want to go on Cobra initially; you can drop dental and vision insurance if you just want the health insurance. You can apply to Kaiser and Blue Cross, and possibly other plans, under business insurance and save a lot of money. You need only 2 employees on the plan and it could be you and your husband if you help him. You can also qualify for group insurance plans through professional groups. anon

The most important thing is not to have a gap in your medical coverage. Companies look harder when there's been a gap in coverage because they assume you have unmet healthcare needs. So COBRA first is a good idea. Nationwide has the most liberal criteria I found in searching for individual health insurance. You have to join the CA Farm Bureau (anyone can) and then you can apply for Nationwide. I really like the company; they pay claims, answer their phones with live people and have CCN as their provider network, and that's huge! Good luck! Joanna

Husband left his job - alternatives to COBRA?

August 2003

My husband recently left his job. The COBRA option is ridiculously expensive for our family of 5. Does anyone have any recommendations of how to go about researching private health insurance carriers or which ones are worth checking out - which ones to avoid? We are open to HMO or PPO. Thank you. N

Health insurance is an expensive proposition. I try to help my patients make a decision like this: You buy homeowners or renters insurance for much less money than most people pay for medical insurance, but you don't expect the homeowners insurance to cover replacing lightbulbs. You have that coverage for catastrophic needs like a fire or robbery. If you are the average healthy family, you do not utilize 5-10 thousand dollars per year of medical care, so why would you want to pay premiums of that much, just to avoid paying for the occasional doctor's visit?

My recommendation is that you look for a PPO plan which allows you freedom of choice of your providers and hospitals (although your copay may change for our of plan providers)and has a high family annual deductable. A healthy family is hard pressed to spend even the highest deductible of $4500 per year on medical care, and your premiums can be low because you are not asking the plan to 'pay for your lightbulbs'. However, in the circumstance that there is surgery required or some other serious illness, you have coverage for this catastrophic event.

Some of these plans also allow you to save money in a tax deferred account called a medical savings account. It earns interest tax deferred, and can be used to pay medical bills. With many of these plans, if your saved money is not used for medical bills by the time you reach retirement age, it can be used for retirement also.

A good plan which has both of these options is the Blue Shield MSA plan. I purchased mine through a broker called Jim Fleming. You by no means need to contact him, but he is constantly reviewing insurance plans, and has the most up to date information, so he does the shopping around for you. His phone # is 925 891-3000

I highly recommend putting the majority of what you would pay for premiums for a low co-pay plan into an MSA. Why pay premiums for what you hopefully will never use anyway? Good Luck elizabeth lee

I am in a similar situation and found that Kaiser is about half what our COBRA would be: $527/mo for a family. Still steep but much easier to handle. I have been on Kaiser before and found it to be fine if you can advocate for yourself. jen

my husband and i are self-insured. we have the blue cross PPO plan. i did a lot of shopping and comparing to find it and worked through a broker (who unfortunately is no longer practicing). i highly recommend the experience of working with a broker -- saves you time and money in the end (you pay nothing; they get commissions from the HMOs). i know quite a few families who find the blue cross PPO to be affordable (comparatively speaking, i suppose) for them. alternatively, depending on the situation, the blue cross HMO can sometimes be more cost- effective. although they are as irritating to deal with as any managed care organization, you can sometimes get a good counselor on the line with customer care who will work the numbers for you and figure out which plan would be most appropriate. in some cases it seems that people with children do better on the HMO. hope this helps. Kim

One way to inverstigate health insurance is to call a broker. Brokers get paid by the health insurance companies, so it is good to find a broker that works with several different companies to make sure that they are truly recommending the best plan for you and not the plan that gives them the most commission. Brokers are also helpful because, assuming you find a good one, they are often familiar with the plan specifics and can help you if any questions arise on your plan.

A broker that I would strongly recommend is Carman Insurance Services. They are located in North Berkeley and it is a husband and wife team, Andy and his wife Dawn. I have briefly worked with them, both as an employee and also years later when they helped the small business that I worked for. They are very involved with all of the companies they help, and they specialize in small businesses and personal insurance. Their number is 528 4781. Feel free to say mention you got their info from me.

Good luck figuring out all the confusing health insurance stuff! ~Nicole

New to the U.S. - what if husband loses his job?

May 2003

I am coming from a country where everybody is covered by health insurance and I am very shocked that a rich country like the U.S doesn't see it as important to cover everybody. Right know my husband has a pretty secure job and me and my daughter are covered under his insurance. I am just wondering what would happen if he would get very sick to the point that he couldn't work anymore. How does health insurance at your work help you in this case ? Do they still cover you for years if you would have cancer for example ? If he would buy private insurance how would he come up with the money if he doesn't make any. I made only 250000 Dollars a year before I stayed home with our daughter so I couldn't pay for it either. I did have health insurance at my old job but I just went with my husbands health insurance. When I start working again should I sign my husband and daughter also under my health insurance just in case something horrible happens to him. I am very confused about this whole issue. I would be very thankful for any advise.

Yes, it is amazing that health insurance is not a given in the US. If your husband were to lost his job for some reason, you could keep the insurance for up to 18 months (COBRA), but would have to pay for it yourself. Often, an exorbiant sum. For our family of three, it would be more than our mortgage each month!

Many people switch to high deductible or catastrophic coverage, or try something like Kaiser, a lower-cost HMO that people seem to either love or hate. If you have any sort of pre-exisiting condition (such as asthma, a disease you have recovered from, or the insurance company just doesn't want to cover you) then you might run into trouble. The state of California has some very weak coverage for people like this, but it also has a very long wait list.

My recommendation to you is to hope that you can keep coverage through your husband's work. If for some reason that falls through, you can always get a part-time job at a place like Starbucks and get great coverage for your family (lots of moms do this!), or find a full-time job that covers you all.

Also...State Senator Perata is trying to pass two bills (I believe one is SB921) to help with this very situation. You can find out more about them and ***voice your support*** via
Capitol Office State Capitol Room 4061 Sacramento, CA 95814 Phone (916) 445-6577 District Offices 1515 Clay Street, #2202 Oakland, CA 94612 Ph (510) 286-1333 e-mail Senator.Perata [at] sen.ca.gov http//democrats.sen.ca.gov/senator/perata/ Another site that covers this issue is http//votehealth.net/articles/sb921.html
--advocate for affordable, quality health care for all

Husband lost his job - options for paying our own health care

April 2002

My husband's just lost his job and with it our benefits, and so we're looking into various options for paying for our own health care. COBRA is hugely expensive, so that's not an option. One thing we're considering is buying catastrophic health coverage for the family and paying for our routine care out-of-pocket. I'm wondering if other families have done this, and how it's worked for them. What are the pros and cons? Who did you buy catastrophic from? Did you use a Medical Savings Account? And, if we do decide to buy our own health insurance, what health plans -- in addition to Kaiser -- have affordable options for people buying their own insurance? nelly

I don't know whether you want to stay with your current doctor(s) or not, but you can see an instant quote for Kaiser Permanente's Personal Advantage plan at: https://ehealthplan.kp.org/ApplyOnline/index.html Good luck! - Sharon

I think Kaiser is a fabulous insurance plan for a family. As an example, for a family of 4, i.e., 2 kids and 2 parents in their 30's, it's about $440/month. It's comprehensive, accessible, and I've found the physicians to be terrific. It's nice to have your provider, your spouse's and your child's all in the same location. Everything is in their database, no need to worry about referrals being authorized or not, etc. We've had at least 4 other insurance plans, and Kaiser is by far, the best. We've had no complaints. It may seem like a ''factory'' at times, but I find it to be a very efficient one. They even make appointments to specialists or other departments for you! This is unheard of elsewhere. And, if you're not happy with your doctor, you can always change, or shop around. just my two cents. Good luck. Even $440 is a lot of money, so it's important to be happy. Anon.

When I researched this two years ago, the cheapest plan I could find was Kaiser which is an HMO. As a family of four, with the main subscriber in her mid-thirties, we are paying $440/month. Our co-pay is $15 per office visit. Kaiser can be great if you know how to work the system. They have great doctors, although it can be hard to find good ones taking new patients. After years of being with Kaiser, I still haven't found a primary care provider for my husband and I, although we are very happy with the kids' pediatrician. Daphne

I've had good luck with an MSA -- a medical savings account designed for self-employed people. Blue Shield offers a high-deductible, low-premium plan that works with an MSA (based on my research, I'd say they're the only MSA-compatible health plan worth having in CA). Basically, the account (I got mine through Merrill Lynch) is a tax-deferred savings account for medical expenses. You can get any vehicle you want - mutual fund, money market, etc. They give you a Visa card to use for all your expenses. It works pretty well, and helps ease the sting every April 15. sonya

I am a self employed plastic surgeon in Berkeley, so I have examined health insurance issues from both sides. Health insurance is a problem as it is often expensive and difficult to utilize. For the average, healthy family, health care utilization usually includes annual checkups including some testing for the adults, mammograms, pap smears, blood work, etc and perhaps a few sick baby visits to the pediatrician. This in general, should cost less even if you were paying out of pocket than your premiums of $600 per month. In my opinion, the best health insurance plan out there is a PPO plan with a high deductible and low premium cost. This would become of use in the event of an illness requiring hospitalization or surgery, and for most of us, thank goodness, that is a rare or nonexistant event. Blue Shield has some programs like this. It also has a program where you can set up a medical savings account, one which earns interest on a tax deferred basis and can be used for retirement if you have not used it for health care. Most people out there seem to be looking for a way to pay premiums up front and then pay little or nothing to actually see the doctor. You are paying more in premiums than you are likely to ever use. This is wasted money. When you buy renters or homeowners insurance, you are insuring for catastrophic events, not to have your lightbulbs changed for free, it really makes financial sense to view your health insurance the same way. Elizabeth Lee, MD

Both my husband and I are self-employed. I've got Kaiser and he's got Blue Cross (from before we were married). Both of us are happy with the care we get, but the big difference I can see is in price. Kaiser is much more reasonable. His premium is more than my infant son and I combined. Premiums for both of us have been going up, but while Blue Cross will jump up $50-75, Kaiser only goes up by $10-15. Blue Cross has many more out of pocket expenses, as well as a $250 deductable for perscriptions, which hits us where it hurts. I know some people have had problems with Kaiser, but I've received great care there, including having a baby. But unfortunately, for an individual plan, they may not accept people with pre-existing conditions, as was the case for my husband when we tried to switch. Mara