If you don't qualify for any subsidy, you should definitely just purchase health insurance directly through the carrier. I initially purchased insurance via CoveredCA (no subsidy) and they just acted as a middleman between my family and Blue Shield without providing any benefit.
Ask HN: Bootstrapped US founders, who do you use for health insurance?
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Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?
#22Earlier quoted context omitted.
> You have to be near poverty (equivalent in bay area) to get any government assistance. Assistance is for those who need it, not those who willingly choose to live in a high COI area. It is possible to live in CA on $50k/year. Would you pay that assistance back if you had a liquidity event? Probably not.
I'd prefer to not get into a political discussion, but once I get on a health care plan, my full premiums will be subsidizing others, so where's my money back when I don't use any of my health care benefits? Also, you think it's fair that somebody who makes $55,000 pays the same amount for health insurance as somebody that makes $500,000 a year?
I don't think you've fully grasped the concept of "insurance".
Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?
#23That's how I do it, but this probably puts me in the "lucky" category...
Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?
#24Get a spouse who works and is gracious enough to pay for your health insurance via his/her company plan :-) That's how I do it, but this probably puts me in the "lucky" category...
Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?
#25Earlier quoted context omitted.
That is what the high deductible insurance or health savings account is for.
i can't contribute to an HSA without subscribing to a high deductible plan. " basically a membership in a clinic where you pay a monthly fee in order to get cheap access to your doctor... The monthly fee is substantially less than typical health insurance premiums." But... I still need a high-deductible plan to contribute to an HSA to deal with catastrophic issues anyway. high deductible plans are putting colleagues…
https://directprimarycarejournal.com/2014/06/08/how-does-dir...
Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?
#26We just signed up for JustWorks, a PEO, primarily because their healthcare plans are much cheaper than going direct to brokers as a 3 person company. They require 2 people though so if you are solo I don't think this is an option for you.
Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?
#27Earlier quoted context omitted.
> My understanding is that health insurance originated in this country as a means to plump up employee compensation in a situation where paying more wages was not desirable. You could not entice good employees by offering them a pay raise because it bumped them up into another tax bracket and it just wasn't worth it to them. But the way health insurance got handled, if you offered them a benefits package, it increase…
Thanks. I am considering doing a new piece because I get a lot of flack over details like that while people generally seem to miss the point relevant to our lives today that DPC is a legal alternative under the ACA and a genuinely better solution. I am frustrated and not sure what I need to do differently to get that across effectively. Edit: Feel free to nitpick this version: http://micheleincalifornia.blogspot.com/…
I agree that separating disaster/catastrophic coverage (ie: insurance ) from routine things like doctor visits (ie: health care ) is a good thing. I was aware of HDHP and HSA for the former but I did not know about DPC until you brought it to my attention with this comment thread.
Thank you.
Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?
#28Does that include subsidies? I would assume, based on your income as a founder, that you'd qualify for subsidies for plans on healthcare.gov. If you don't (>$60-70k/year income), even high deductible plans are in that monthly range you quoted (my individual high deductible marketplace plan went from ~$290/month to ~$500/month [$9000 deductible], so my wife, daughter, and I are now on a PPO plan at $1300/month).
Any income greater than $50,000 a year does not qualify for any California assistance. $50,000 a year is completely unlivable where I live in the bay area. You have to be near poverty (bay area) to get any government assistance.
Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?
#29What would taxes be if we compared the US to Canada?
Using the following two tools: https://simpletax.ca/calculator https://smartasset.com/taxes/california-tax-calculator
For 50k a year in British Colombia for Canada and California for the US I get the following:
BC: $8,372 CA: $11,112
At 100k with 18k contributed to 401k/RRSP the numbers are 17.5K and 25.8k for BC and CA.
Unless I missed typed something because it's late we Americans are getting a raw deal. I realize Canada has VAT, but CA has very high sales taxes and I did not include the cost of an exchange plan. What you are looking is the Income and FICA taxes alone.
Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?
#30If you don't qualify for any subsidy, you should definitely just purchase health insurance directly through the carrier. I initially purchased insurance via CoveredCA (no subsidy) and they just acted as a middleman between my family and Blue Shield without providing any benefit.
Thanks that's great advice. It seems there is absolutely zero discounts using CoveredCA when you earn more than $50,000 a year.