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Ask HN: small startups, what do you use for health insurance?

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Re: Ask HN: small startups, what do you use for health insurance?

#31

Post by itmag »

itmag wrote: post #23
mixmax wrote: post #15

The Danish state. Glad to see that I get something for my high taxrate.

I tend to think that socialized medicine is a great cost hedge for the individual citizen (ie even in Scandinavia we do pay for health care, so it's not 100% free like some people believe, but the cost is predictable and it can't ever get sky-high like in the US). I think one downside to it is that it's hard to do anything out of the ordinary (ie some new drug or method or whatever) because health care is seen as a s…

I tend to think that socialized medicine is a great cost hedge

Of course, for this to work, there has to be a lot, possibly the majority, of super-payers who pay more into the health care system via their taxes than they receive back.

So, Scandi style health care can in a way be seen as a government-enforced mandatory health insurance, except that unemployed people get it for (almost) free.

Then again, a huge socialized health care system might have better economies of scale (or they might be worse). Also, let's not forget that people can go to medical school for free in Scandinavia, which is bound to have some kind of effect.

Re: Ask HN: small startups, what do you use for health insurance?

#32

Post by georgemcbay »

itmag wrote: post #31
itmag wrote: post #23

Earlier quoted context omitted.

I tend to think that socialized medicine is a great cost hedge for the individual citizen (ie even in Scandinavia we do pay for health care, so it's not 100% free like some people believe, but the cost is predictable and it can't ever get sky-high like in the US). I think one downside to it is that it's hard to do anything out of the ordinary (ie some new drug or method or whatever) because health care is seen as a s…

I tend to think that socialized medicine is a great cost hedge Of course, for this to work, there has to be a lot, possibly the majority, of super-payers who pay more into the health care system via their taxes than they receive back. So, Scandi style health care can in a way be seen as a government-enforced mandatory health insurance, except that unemployed people get it for (almost) free. Then again, a huge sociali…

"Of course, for this to work, there has to be a lot, possibly the majority, of super-payers who pay more into the health care system via their taxes than they receive back."

Yes... but, this is also true for for-profit non-socialized health care insurance.

Re: Ask HN: small startups, what do you use for health insurance?

#33

Post by TruffleLabs »

ryanwaggoner wrote: post #18

For reasons unbeknownst to me, NY is one of the most expensive locations in the US for health insurance. My wife and I are both healthy and have been able to buy good insurance with reasonable deductions for around $250 / month total in CA, CO, and OR. But I can't find anything in NY for less than 4x-6x that much. I find it hard to believe that the cost of care in NY is that much higher than in CA, so I'm assuming th…

It's the stress!

Re: Ask HN: small startups, what do you use for health insurance?

#34

Post by TruffleLabs »

javahava wrote: post #12
TruffleLabs wrote: post #9

There is no cut dried answer in USA. Parameters to review: * what is your (you/wife/family history) current health? * what is your current list of medications and will they even be covered by an insurance plan you like? * how much risk do you want to carry (less premium, higher deductible) vs the insurance plan (higher premium, lower deductible )? * where you live. Certain regions will have higher premiums. * family…

thanks! i have talked to a broker, and he pointed out several different options - all somewhat pricey unfortunately. as i expected, he viewed HSA's as a generally inferior option, thought that was a bit unclear why (i recall perhaps something to do about ease of reimbursement/coverage). not sure if that's actually true. > If you can do it, get a high deductible insurance plan with an HSA for the years in which you ar…

COBRA payments for health care are what the company paid for your healthcare, not just your portion. I worked at a large Fortune 500, my monthly premium was (2006) about $150 a month. COBRA was $985 a month. Personally purchased Family insurance plan was $300 month (though hard to compare these plans for their benefits, just the dollars). Yes, if the large company did a great job in negotiating, super, it may be lower than individual plans.

Having a baby has some uncertainty; is the baby growing fine, is the mother doing well, how will the birth go, what about the first year, etc. That is why I suggest looking at the total costs, the mother's health, and what financially you are willing to take on up front with an HSA. Sorry I do not have a clear path for making a decision.

HSA: there are two parts to this. The high deductible healthcare plan and the HSA account admin. For a healthcare charges up to your high deductible you would pay for it with your HSA debit card or electronic check. The amount still gets sent in to the insurance company so they can record it.

Once your deductible is reached then healthcare costs would still be sent to the insurance company, and based on coverage, the insurance would pay its part and any remainder would be paid by you, with your HSA account.

Any reimbursements issues would be with the insurance plan, hopefully not with the HSA.

Re: Ask HN: small startups, what do you use for health insurance?

#35

Post by mrkurt »

RudySF wrote: post #6

We're a small team of three (25, 28, 28) and the company pays for each person's individual plan with Anthem Blue Cross rather than a group plan which was more expensive for essentially the same coverage. It's about $200 per person per month.

Be careful with that, since individual insurance can and will drop you when things go south. A group plan protects employees from that although rates will go way up if someone has a major health issue of some kind.

Re: Ask HN: small startups, what do you use for health insurance?

#36

Post by scotty79 »

mixmax wrote: post #15

The Danish state. Glad to see that I get something for my high taxrate.

The Poland state. About 100$ per month. Almost in whole deductible from directly from income tax.

Coverage? My life partner had CT, MRI, fMRI, little more than a week of hospitalization, and a brain tumor removed within a month by one of the top neurosurgeons (by Yelp-like recommendations) in Poland. Additional cost? None.

Re: Ask HN: small startups, what do you use for health insurance?

#37

Post by reuven »

mixmax wrote: post #15

The Danish state. Glad to see that I get something for my high taxrate.

We don't have to worry about health insurance in Israel, either. You pay 5% of your salary (up to a cap), and get (from my family's extensive experience) very good care.

The fact that Americans have to think or worry about health insurance -- and that they can and do go bankrupt when they cannot afford to pay for care -- is bad enough. The fact that many Americans then claim that their system is the best in the world, and needs only superficial change, is shocking on several fronts.

I was fortunate enough to have good health insurance several years ago, when my family was living in the US, when I did my PhD coursework. (We only got this good insurance when the university wanted to charge me more in insurance premiums than they paid me for a stipend.) When my wife got sick with something that's very expensive to treat (but was treated and cured, I'm happy to say), we were especially lucky.

Remember, all of you young entrepreneurs out there, that the odds of getting something might be small, but they do exist. You don't want to be without health insurance if that happens. Again, the fact that this is even possible is a uniquely American phenomenon, and a sad one at that.

Re: Ask HN: small startups, what do you use for health insurance?

#38

Post by duncanj »

ryanwaggoner wrote: post #18

For reasons unbeknownst to me, NY is one of the most expensive locations in the US for health insurance. My wife and I are both healthy and have been able to buy good insurance with reasonable deductions for around $250 / month total in CA, CO, and OR. But I can't find anything in NY for less than 4x-6x that much. I find it hard to believe that the cost of care in NY is that much higher than in CA, so I'm assuming th…

Unfortunately, the article doesn't answer the question of why NY had starkly higher insurance premiums before those two rules were implemented in 2009. I was purchasing insurance in NY in 2002-2005 and premiums were 3-4 times what they are in other states. This was before 2009, and partially before Timothy's law, and all that.

I think, perhaps, the fact that NY has such comprehensive support at the low end of the income distribution, through medicaid, family health plus, healthy NY, etc., causes all of those young, healthy but lower-income people to drop out of the market for insurance. This leaves higher-income and older people in the self-insured and employer-sponsored pools, driving up the base rates.

In any event, a study by the Manhattan Institute, as referenced by the article, isn't very trustworthy. It would be very hard for them to release a study that said anything different, which to me means that there is inherent bias.

Re: Ask HN: small startups, what do you use for health insurance?

#39

Post by amorphid »

I just went through this process. For my team of four, we went with an Anthem Blue Cross PPO,.allowed us to provide health coverage for a remote worker in a different state. My recommendation is to find a good insurance agent who can help you choose. We went with Brad @ http://www.allpointe-is.com in San Francisco. He was really helpful. In case you are wondering, using an insurance agent does not cost any extra.

Re: Ask HN: small startups, what do you use for health insurance?

#40

Post by [deleted] »

ryanwaggoner wrote: post #18

For reasons unbeknownst to me, NY is one of the most expensive locations in the US for health insurance. My wife and I are both healthy and have been able to buy good insurance with reasonable deductions for around $250 / month total in CA, CO, and OR. But I can't find anything in NY for less than 4x-6x that much. I find it hard to believe that the cost of care in NY is that much higher than in CA, so I'm assuming th…

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