After getting yet another email a few weeks back from a reader, suggesting a post on health insurance for freelancers, figured it was time. I know this is a hot button issue for any commercial freelancer, often looming as one of the key issues giving salaried employees/aspiring commercial writers pause when considering the leap to self-employment.
If you’re single and in good health (like I am on both counts), health insurance really shouldn’t hold you back from the commercial freelancing life – psychologically or logistically. As I see it, there are far bigger boogeymen (usually imaginary if you’ve planned well) facing free agents like us. Will I go broke? Will I lose my house? Will I be reduced to standing on a corner with a “Will Write Copy for Food” sign? Nonetheless, it’s still one more thing to consider.
Since 1997, I’ve used Kaiser Permanente. I rarely step foot in the place (but you’re paying for peace of mind), but over the years, have been pretty impressed with their offering, services and thoroughness.
I’m not crazy about the fact that, like clockwork, my premiums go up every year by roughly 15+ percent, but all in all, I still pay a not-unreasonable $325 a month. Co-pays for doctor visits are $30, and a surprising number of other services are covered or subject to co-pays (as opposed to coming out of pocket to satisfy your deductible).
Women will typically pay more for health insurance than men of the same age, but depending on the plan, and the deductible and co-insurance level chosen, a single person of either gender can generally find a manageable plan out there.
And with some of the new clauses of the healthcare bill, you’ve got more protections than may have been the case in the past. And do NOT try to drag me into a debate on THAT issue; ain’t gonna happen. I will ignore you and delete your comments. No hablo ingles…;)
For those pondering going without – a temptation for singles in good health and feeling bullet-proof, I wouldn’t even consider it. Not worth it. One accident or illness and you’re in deep doo-doo.
And yes, if you have a family, it’s going to cost a good bit more. Not every freelance commercial copywriter has a gainfully employed and benefits-laden spouse to cover that base. But a quick look at Kaiser’s plans turned up plans in the range of $600-800+/month for a family of four, depending on options chosen (don’t take these figures to the bank; that’s Georgia. Your mileage may vary, etc, etc.).
Not great news, but not necessarily a deal-killer, either. Remember, stay in a job you hate, just for the bennies, and your health will likely suffer. Sort of defeats the purpose.
For the uninitiated, here’s a basic overview of an HMO. As a member of Kaiser, getting insurance on my own, I’m put in with a certain group of subscribers. I have no choice in the matter – that’s the nature of the HMO model – and I don’t know who they are (i.e., we don’t catch up for coffee…).
The nice thing about the HMO group model is that individual consumption of services doesn’t directly affect one’s rates. That’s good news and bad news. Good news: if you use a lot of services in a given year, you won’t be singled out for a skyrocketing rate increase. Bad news: even if you don’t use it at all, your rates will still go up every year.
A few resources:
For more information on health insurance (as well as life and disability insurance), click here.
To find a health insurance agent in your area, click here.
For insurance plans for creative folk, click here.
Assuming you don’t have a spouse with benefits, what do you do for health insurance?
If you have a family and had to get insurance on your own, how did you go about finding the best deal?
Any good health insurance resources you’ve come across for the self-employed?
Any strategies you’ve employed to get the most from your health care dollars?
Greetings All,
For any freelancers in Oregon, Idaho or Montana, PacificSource Health Plans is a good one. I have a plan with a $2500 deductible that costs $147/month. Very affordable. Also, there’s an organization called the Freelancers Union that offers health and dental insurance depending on where you live. An excellent resource.
Here are the websites:
PacificSource Health Plans: https://pacificsource.com/
Freelancers Union: https://freelancersunion.org/
Hi all!
Great discussion. Thanks for all the helpful info.
This is a topic near and dear to my heart, because health insurance is one of the major reasons why I haven’t left my crummy job, which is not even in the writing field. I have a pre-existing condition that precludes me from getting individual health insurance. I also live in California, and the waiting list to get into the state-sponsored, high-risk insurance pool is months, if not years, long. It’s also expensive.
Currently, I have corporate-subsidized medical benefits through Kaiser. My employer pays more than half of the cost of premiums. I looked into what COBRA would cost, and for just me, the premiums will run about $300 a month. I have paid for COBRA in the past, and it’s served me pretty well. Granted, it’s expensive, but it gets the job done. However, if there was a less-costly alternative available to people like me with pre-existing conditions (before the 2014 regulation goes into effect), you can bet I’d jump on it!
And as an aside, I understand first-hand how “suffering” through the daily grind at a job you despise can take a toll on your health. As a result of my current job situation, I have chronic panic attacks, headaches and stress, coupled with fitful sleep and what feels like never-ending exhaustion. I’m also seeing a psychiatrist and a psychologist through Kaiser to try to manage the stress. Couple that with being a single mom to a four-year-old, and well, I’m tapped out.
I plan to make the transition to full-time freelance writing sometime this year if all goes well. I have a few lukewarm irons in the fire, so I’m hoping for the best.
I never even heard of a COBRA payment as low as $300! I am in awe. Remember, COBRA is only 18 mos…
Those high deductibles–just be sure you never need surgery or any big ticket item under the deductible–that doctor will want the whole amt you have left on the deductible upfront.
Regarding pre-existing conditions, I think it depends on what the condition is. In my experience, cheaper insurance companies put a lifetime rider on them, meaning they won’t cover anything related to them EVER. That’s the kind of company you don’t want to deal with because you know they’ll just nickel and dime you on every claim. When I went with Aetna, they said they wouldn’t cover my pre-existing condition (gallstones) for one year. By that p0int, I had gone a full year symptom-free so I was completely covered from the start. I still have my gallbladder, so that stance turned out to be to their benefit.
John, I think most of us got higher increases last year than in previous years. Mine also got raised twice, which I thought was illegal. When I questioned it, I was told it was a statewide increase. My bet is that what it really was was a way to stockpile funds in response to the healthcare reform.
Robyn, I agree with Star. If you’re able to get Cobra for $300 per month, consider youself lucky, but as she pointed out, be aware you can only stay on it for 18 months. If your pre-existing condition is such that you can’t get insurance elsewhere, you could be in big trouble once those 1.5 years are up. I’m so sorry you have to suffer through a job you don’t like solely for that reason. Aren’t we (Americans) the only civilized country in the world where we even have to worry about such things?
Something to consider in addition to the high-deductible plan – set up an HSA account you contribute a set amount into each month. The purpose of the HSA is to cover the high deductible. The money in the HSA is yours, doesn’t have to be spent by the end of the year and generally is in an interest-bearing account. Granted, building an HSA up to 5 or 10k won’t happen overnight, especially if you are withdrawing for Dr. visits in the meantime, but let me tell you, having a specified “savings account” is the way to go with a high deductible plan. The trick is, once you reach that 5-10k, continue to contribute funds to the account. You’ll find you don’t spend the full deductible every year.
I think there are some restrictions on what you can spend HSA money on. No? Yes–it can be carried over.
@Star — Yes. And those restrictions were tightened substantially this year. You can only spend HSA money on medical bills like prescriptions, doctor visits, hospital expenses, etc. No over-the-counter stuff (some of the stuff I used to get by prescription is now OTC, so I can’t use the HSA money anymore), but I still use mine for prescription glasses. If you die with any of it unspent, it goes to your heirs.
We also are able to use our HSA for dental bills as well – which is a huge help considering how chintzy dental insurance is. I’d have to check into it further, but I do believe some OTC meds are covered under HSAs provided you have a Dr.’s prescription for it.
Dental insurance is chintzy because it isn’t really insurance. It’s basically pre-paid dental with an extra handling fee tacked on by two or three middlemen, and a hefty deductible tacked on to your end. I mentioned the Faustian bargain for doctors in my blog post; dentists have completely bought into that arrangement, hook, line, and sinker.
Insurance is trading a small, known loss for a large, unpredictable potential loss. Trying to use insurance for any other purpose will cost you lots of money, because the insurance companies are much better at prediction than you are. But what has happened is that people have demanded pre-paid medical plans, and the insurance industry has been happy to oblige, because there is TONS of money in that business. That type of ‘insurance’ is the reason medical care costs so much. It has completely removed competition from the medical provider.
I have seen some attempts at “collective bargaining” outside of the insurance business for medical consumers, but they suffer from the same problems as insurance — without the oversight of any regulatory body, so most of them are out-and-out scams (hint: if it is sold in an MLM, it’s a scam). I ran into a couple of them while I was trying to make a living selling insurance. It’s really tough to try to apply anything resembling competition to a group that has adjusted to not having any, and I would view any claim that it can be done with a truckload of salt.
The state of medical care is pretty dismal right now, and Dear Leader is about to make a bad situation really awful (unless he is stopped). I’ve already had a taste of that — I get my medical care from the VA, mainly because I can’t afford anything else (insurance, if I c0uld get it, would run over $1500/month for me, and would not cover anything that might actually happen). I requested an audiology exam about a year ago, and I might get one in about another year. Maybe sooner, if somebody in front of me on the wait-list dies. Thank goodness I’m fairly healthy and fit!
Thanks for weighing in on my insurance dilemma.
In the past, I was covered under COBRA for the initial 18 months. Once the time was up, I was able to obtain coverage under CAL-COBRA, an extension program that allowed me keep my benefits for an additional 18 months. I think the premium may have increased slightly, but I can’t recall.
I also don’t recall paying higher deductibles under COBRA. I was able to keep the coverage I had with my previous employer, exactly as it was. The only difference is, I had to pay much more for it.
My pre-existing condition is a mental health issue, and it’s a borderline diagnosis. Unfortunately, the term is on my medical record, so most insurance companies won’t touch it.
Thanks again for the advice!
I’m going to chime in here as a newly full-time freelancer with a self-employed spouse (life insurance sales). Like Peter said, health insurance for a reasonably healthy person is not that expensive and it’s not that bad for a family.
Here’s something you all need to know – employers are the ones getting ripped off. I’ve gone from paying about $400 a month on a employer HSA ($4,000 deductible) to paying $340 for the same EXACT policy under the individual coverage plan. My employer was paying over $400 a month for me to have that policy. I get my wellness coverage plus 100% in network expenses paid after the deductible.
Plus, the HSA is a nice tax break for my family. Instead of worrying about paying $20 to see a doctor, we just know that we have to pay for our basic illness appointments and we think twice about going to the doctor for every sniffle. The insurance companies have tricked us into the “co-pay” mentality.
If you break it down, an HSA is going to save you money on premiums, unnecessary trips to the ER/doctor (you won’t go if you know it’s out-of-pocket), and you get to grow that savings account the rest of your life. Thinking about health insurance like a long-term investment is a good idea. Your spending the money up front (HSA funding) to have the money later to cover your expenses.
With respect, of course, it’s a little concerning to “think twice” about going through the doctor because of cost. My concern is getting into the “oh that mole’s only a little discolored” mentality. Would rather go to the doctor when it’s a little sniffle instead of the hospital for full-blown pneumonia (for example). Just a thought.
But Amanda, what is your deductible? For most people with low premiums (like the one you describe), a massive deductible is part of the equation. I disagree that “it’s not that bad for a family.” As the breadwinner for a family of 5, it was very, very bad. I couldn’t find a plan anywhere near the $300-400 range you describe, not even back in 2004 when I started freelancing full-time.
Michael, Let me clarify. “Thinking twice” is waiting until the morning for a sore throat and cough to see a primary care physician versus going to urgent care. Or trying a round of antibiotics before going in for a gall bladder exam. (Two very recent decisions I made). If I felt it were a life/death situation, I would spare no expense to fix the problem. It’s just being wise with your dollars that I’m talking about.
Rick: My deductible is $5,000. I do not consider $5,000 toward my family’s healthcare unreasonable. I would be responsible for that on any given PPO plan with an 80/20 split. So, I look at it as a savings in premium, a tax break and money that I control, not an insurance company.
Having recently watched someone endure million-dollar medical bills, I unfortunately can’t relate to the line of reasoning some of you have. Correct me if I’m wrong (and I very well could be), but with an HSA, you put away something like $5,000 every year. Let’s assume that after 20 years, no one in your family has any kind of major medical emergency (which is really pushing it). That still only gives you $100,000 to draw upon. Now I realize that most HSAs also provide catastrophic coverage, but there are usually limits on that with major deductibles involved. Admittedly, $4,000 is not bad, but I’d be sure to read the fine print carefully on that (e.g., in full up to what amount?). The idea that an HSA is actually like a secondary retirement fund is an extremely far-fected notion to me. Trust me, you *will* need that money some day for its intended purpose. And ALL health insurance plans are tax breaks for the self-employed. You needn’t resort to an HSA for solely that reason.
When I or someone I love is sick, I want the best care (tests, doctors, etc.) that can be had. I don’t want to be putting off a cancer diagnosis for one month (or longer) until it’s too late while an antibiotic or a wait-and-see approach is tried first. Likewise, I don’t want to have to say no to the best doctor in the country because s/he is not part of my network. I’ve actually witnessed both of these experiences NOT transpire with loved ones because they had the proper insurance and insisted on the most expedient tests and best surgeons. To me, that’s worth paying more for. I wish that I’d gone through life not having had to learn these lessons, but since I did, I hope I can provide some food for thought to some of you who’ve been more fortunate than me.
My HSA is the same health insurance that I would receive at an employer. It’s with United Healthcare (one of the largest healthcare providers in the U.S.). I get the same treatment at the same facilities my Blue Cross Blue Shield counterparts get. An HSA is just a high deductible insurance policy that puts initial burden on the consumer in return for lower premiums. Plus, the money is invested in the HSA account (just like an IRA). And, it is a secondary retirement account. It can be a supplement to your healthcare expenses as you age.
The current IRS contribution limits (tax-free) are $3,050 for an individual and $6,150 for a family. It’s worth investigating is all I’m saying. And, I’ll be happy to have $100K or more lying around for healthcare expenses.
But my point was, unless you’re VERY, VERY fortunate, you won’t have $100,000 lying around. You’ll have tapped into that savings (and then some) long before it ever reaches that amount. It’s definitely worth exploring, but so is a traditional healthcare plan.
An HSA is not health insurance, at all. That’s like saying an IRA or a 401k is the same as life insurance. Also, HSAs have been sold to the general public as some kind of solution to the health insurance mess, which is a joke; they’re a great idea for high-income folks who are looking for yet another way to avoid taxes, but they do nothing to protect people from financial vulnerability related to their medical care.
Statistics also show, Rick, that many people don’t fund their whole plan and don’t get the high deductible policy.
I’m behind on my blog reading but when I picked this one up I couldn’t put it down. I’ve been self employed for 10 years and have tried more than a few combinations to insure my family of 7, including working a part-time job that provided insurance. I’m like the writer above who said she’d rather live in a tarp than have employee stamped on her head, so we’ve found ways to work this out – not always elegant and requiring some research, but doable. I also agree with Rick above, that replacing a 70K job is not apples for apples, I’ve worked hard to maintain an income between 100K-200k, and pulled it off until the recent recession years. Not sure if that kind of horsepower will ever come back in this field so I’ve added some other activities to continue avoiding the employee stamp. Health care expense is just a fact of life that needs to be factored into the equation, but there are ways to control the cost if you are creative.
I found the high deductibles, health savings plans and other plans that avoided small co-pays, etc. to be my best bet. For my large family, our out-of-pocket was the same whether we had bells and whistles or not, so I keep a hospitalization policy for the disasters, plan to pay out of pocket if necessary (we are all very healthy and low maintenance), but at least I save on premium, and still keep my premium below 700 per month. For example, on the broken ankle mentioned above, my bill still would have been around 10K, but I at least pay it on the back end and not on the front. A year ago, I had to have an MRI for one of my sons and did the same as Peter, asked his orthopedic doctor (sports injury) to find me a deal so I could pay cash – 350 bucks – payable at the time of service, but a very good deal in my opinion.
I know there are other factors involved, like reproductive diseases and safety risks. I just find it amusing that women pay more for health insurance. People are going to flame me for saying this, but when you think about somebody getting hurt pulling some outrageously stupid stunt, what gender comes to mind? 😀
I’m finding health insurance to be the main issue that’s causing me to consider going back into the employee line.
I’m single, not yet 30, and am in generally good health with only a couple of minor problems. Only one of those is treated. The other I think is a diagnosis based on a severely flawed test.
I’m in Missouri, which apparently means that few companies offer few plans.
I’m currently on COBRA with Anthem Blue Cross Blue Shield, and it’s $134 a month due to federal subsidy. But…. the coverage is for a very tiny area, and I’ve moved. So, the nearest covered general practitioner is more than an hour’s drive one way. It’s a POS (the actual title they give it, but I have my own words for those letters).
I tried to switch from the group plan to an individual plan within Anthem that would have been a PPO with $3,500 deductible and $170 a month. After several rounds of debate and appeals and the most vague answers I’ve ever heard, I was offered instead offered a plan for $1,100 a month.
That led me to check out Humana. They can’t cover me because my zip code doesn’t have any medical facilities in it. I live ten minutes from a medical group, but that doesn’t count. Humana could offer me some plan that didn’t cover doctor visits, lab work, or prescriptions, all for $384 a month and a $3,500 annual deductible. I guess it’s a discount card.
Anyway, I’m getting nowhere with finding insurance for me.
Anthem took me all the way through the underwriting process, then in the “you’ve been accepted” letter notified me that my monthly rate would be ~50% higher due to weight. Understandable, but it still felt like a bait-and-switch.
My life has certainly taken a turn since I wrote the above comment.
Recall what I said about women being a higher risk due to reproductive diseases and safety risks? Two years ago, my reproductive system tried to kill me. As this is a gentleman’s website, I won’t go into details.
My unemployed husband and I were insured under my employer’s plan. In the fall of 2013, when the ACA marketplace opened, they closed the store where I worked, and laid off everyone whose family was eligible for insurance benefits.
“Affordable” care has been a nightmare. I am thankful that people with pre-existing conditions are eligible for insurance, but if they can’t pay for it, it makes little difference.