
How much are your US insurance premiums for self-employed people? - wil421
I was curious how much self-employed people are paying for healthcare for single and family plans. I was commenting on another thread and the suggested premium for someone making $50k was on the high side.<p>If you could ballpark your income that would be great.
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shartshooter
$0.

I'm a veteran with a disability rating of 40% after several deployments
overseas. This means I get free healthcare for life through the VA(although my
family is not covered through the VA, instead through my wife's employer).

If I didn't have VA coverage we'd have to spend $800/mo for me to be added to
my wife's plan. Incurring an extra $800/mo out of the gates would have likely
been a non-starter.

That was a _significant_ factor in my ability to step out on my own.

It feels like America is really hamstringing our entrepreneurs by not having a
medicare-for-all or some other public option.

~~~
fastbeef
This weirds me out so much about US. It is (was?) touted as a beacon of
entrenourship and savvy business thinking, but a lot of things seem to be
right downward hostile towards business.

The parent is an indication of this - he wouldn't have considered starting a
business unless his health care was taken care of. Other things like taxes,
beaurocracy and legal matters seem extremly convoluted and unfriendly to
business when compared to Sweden, which is often painted a socialist.

~~~
pietroglyph
When people say the US is business friendly, I think they’re really observing
that the US is big-business friendly.

Convoluted taxes allow big business and the very wealthy to evade them more
easily.

Convoluted bureaucracy makes it easy to get ahead by working the loopholes,
which you can only do if you’re big enough.

Same thing for other legal matters.

All of this is really a cautionary tale of regulatory capture pushed by vested
interests, usually at the expense of working people.

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throw2589725
$500/mo/person for ACA (Obamacare) HMO Silver Plan in Illionois. It comes out
to $12,000 per year for a family of two adults, no kids. This is fully out of
pocket without subsidies.

HMO means you have to go to specific providers, and get referrals for any
specialists. Silver plan means the deductible is about $2000 per person before
insurance starts paying, then various levels of co-insurance until you hit a
spending cap of about $7000 per person. Only family doctor and referral
specialist visits are fixed price, at $30 and $60 fixed copay, respectively.

EDIT: comparatively speaking, a PPO silver plan (you get to choose your own
doctor) would go up to about $800/person/month. And a gold plan with lower
deductibles and lower coinsurance would be $1000/person/month and more.
Basically, if you end up going to a doctor for anything serious, you end up
paying $thousands out of pocket anyway, whether due to monthly premiums on
gold, or deductible on lower plans.

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PaulHoule
I think it is open enrollment season; log on to your local Obamacare site and
check.

In New York, off the top of my head, premiums are something like $250 a month
for an individual plan, I think $900 for a family for a high deductible plan
that probably won't pay anything next year.

When the subsidies are factored in for a family that earns $50k a year, I
think you wind up paying about $70 a month.

If you are not destitute but have a fairly low income (say $35k a year for
that family) you qualify for the "Essential Plan" which has a $20 a month
premium and a low deductible.

~~~
ajeet_dhaliwal
I don't live in the US but asked some colleagues in New York how much it would
be for a self employed person with a family (of 4 as an example) and they told
me around $20K/year. Your figures are very far off that, what gives, is it
because there are so many options it's like choosing anywhere from a low end
to a high end restaurant?

~~~
flyingfences
In essence, yes. GP quoted figures for a high-deductible health plan. The
premiums are low because the deductible is high - you would have to pay
thousands of dollars of any medical bill out-of-pocket before the insurance
plan would start to cover expenses. Low-deductible plans (insurance covers
practically all of any bill) are available, but the premiums are substantially
higher, especially for higher-income people ineligible for government
subsidies.

~~~
e1g
$20k p.a. is a low-end estimate for minimal cover and high deductible. Here
are the actual plans from Oscar for NYC ->
[https://assets.ctfassets.net/plyq12u1bv8a/1ffUyjqSleteGxYkSq...](https://assets.ctfassets.net/plyq12u1bv8a/1ffUyjqSleteGxYkSqRN2T/3b77eb76be665039019f09681f4a2a46/New_York_Plan_Grid___Rates_English_111219.pdf)
Likewise, for a single, min cost in 2020 will be $500/mo.

GP figures might exist in NY if it's a) a very low-income situation or b) a
generous employer that covers most of the cost, and the employee's
contribution is minimal. Neither applies to a typical self-employed family.

~~~
ajeet_dhaliwal
That link is something to behold, tiers within tiers.

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guidoism
Unfortunately this completely depends on how the state implements the
subsidies. For a family of 4 in my state, $50k will get you a $0/month Bronze
plan or $1500-2000/month for the Silver or Gold plans. As far as I can tell
the only benefit for the Silver and Gold plans is that you pay for your care
ahead of time so it seems like you are paying less for each visit.

~~~
toast0
From my recent plan shopping in Washington state, the silver and gold plans
looked like they might save you money if you were likely to use a lot of
services, but not hit the out of pocket max (i seem to recall out of pocket
max plus premiums was pretty close for all the plans); it felt like silver and
gold might cover a couple things bronze didn't, but it's pretty hard to
actually compare these things, because you have to go through so many layers
of plan documentation, much of which isn't easily obtainable.

~~~
guidoism
The situation is absurd. healthcare.gov is supposed to help us figure out
what's best but you can't export any of their info. I have to hand-create a
spreadsheet every year using information from the that website in html form
and then for the plans that look promising I have to go into multiple PDFs and
pull out information. It's all so opaque.

It's even more difficult in my case because I can decide on my income ahead of
time since it's almost all capital gains. The only way to see how the plans
change when your income changes is to delete your current application and
resubmit it, fortunately the info is all still there. But you still have to
repeat the html and pdf -> spreadsheet process.

It's become very helpful to understand cutoffs like 200% FPL and 218% and 400%
and concentrate around there.

I'm happy for ACA as it allows me to contribute to the industry outside the
confines of a medium or large company, but it’s clear that the whole
healthcare system needs to be burnt to the ground eventually.

~~~
jjeaff
There is a "compare" function. But I think you can only compare 3 or 4 at a
time.

But in many cases, I think silver is the sweetspot for anyone who plans to use
a moderate amount of healthcare.

Bronze if you just want catastrophic coverage.

The plans above bronze rarely offer much benefit for the price.

I would focus on comparing all the silver plans.

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poulsbohemian
Exact income is irrelevant here, all you need to know is if you are above or
below the ACA subsidy line. Having been self-employed in Washington State both
pre-and-post ACA, the actual $$ per family member hasn't shifted greatly, but
choice of plans became more limited. Currently paying ~ $375/mo for myself
(ACA Bronze equivalent), with minimal (~$10/mo) increase for 2020. When I had
the kids on my plan, they were a bit less - last time I paid for a full family
plan (two years ago), it came in at approx. $1100/mo.

I've been with all of the major carriers in the state. Cost differences are
minimal and any coverage differences are impossible to compare. Health
insurance in the US has become exactly like auto insurance - you pay cash out
of pocket and just pretend you don't have insurance until something really bad
happens.

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TurkishPoptart
I hate this country.

~~~
Bubbadoo
Funny, things were substantially different here in the US back around
1999-2004. Cost of living was substantially lower and consumer pricing was
actually better in the US than elsewhere. Fast-forward to today and we're all
being gouged by the telecoms, food prices, tuition bills, health insurance,
real estate prices... well you get the idea. What's the big difference between
then and now? Many, many mega-mergers. For example, back in 1999 there were 17
major airlines. Today there are four. The government plays a big role in this,
as do the major corporations since they draft their own legislation and have
their bought and paid for politicians sponsor the bills. I've heard the
situation summed up as: in Europe, the governments work for the people. In the
US, the government works for the big corps and that means, it's not working
for the people.

~~~
sfttty
Isn't this expected? The capital growth is proportional to its size. Unless
there is something that restricts it's growth, it will absorb all smaller
players.

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bradneuberg
On COBRA, wife and 2 year old kid. I pay 1900 per month for Anthem Blue Cross
plus dental and vision benefits. I’m in California. I’m self employed and
COBRA runs out soon, but everything on the exchange is about the same amount.

~~~
rossdavidh
Have you checked on Health Sherpa? I pretended to be a San Jose, California
resident with a spouse and a 2 year old kid, making $100,000/year, and it
showed me bronze plans starting at ~$700/month.

Your age, etc. may cause this to be different, but I think there's a good
chance you can improve on $1900/month.

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codegeek
Don't know about individuals anymore but in the East Coast area (NY/NJ), a
family of 4 would cost you about $2000/Month for an OK plan.

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crobertsbmw
I pay about $475 a month for a HealthShare program through Liberty Health
Share (for my entire family). It qualifies as insurance for tax purposes, but
they are very clear that it is not insurance. But IMO it's a much better
option for people living a healthy lifestyle.

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rossdavidh
You might want to check Health Sherpa, it does a decent job of sorting through
your options for you. I live in Texas, and am in my 50's, and for me and my
family it's around $1000/month. I am above the ACA subsidy line.

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tshannon
It's kind of blowing my mind how different the prices are state to state. $900
for a family plan in New York? I pay $1600 in MN for my family plan in MN.

~~~
e1g
It’s the same cost in NY. The “$900” figure given elsewhere is either outdated
by a decade, or the plan is heavily subsidized by the employer. $1,600/mo is
the minimum a self employed family would pay.

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jblake
Self employed in CA, single, $225 per month, no subsidies.

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cm2012
$1300 per month for two 28 year olds in NYC

