Ask HN: Freelancers in the US: What do you do for health insurance?

I started freelancing in 2012 with BCBS of MI. Being young-ish and healthy with no kids, just a spouse, I was paying something around $200/mo for a PPO with an HSA (side note: get an HSA and save - it's your best option for not being screwed as a freelancer). 3 years later and the AHA has left me at $400 a month for a HMO (downgrade), higher deductable (downgrade), but thankfully I still am allowed to use an HSA (HSA compatibility is complete bullshit, BTW).

Everything is out of pocket except some bare minimum prevention stuff. Everything trip to the doctor involves me wondering if it's really worth the money and the hassle (thanks to the HMO I can no longer see my old family doctor).

Those of you bound to say that I should shop around using the marketplace - yup, I did. This was the best deal. Insurance is dependent on geography. I'd love to see an app that told me which address would give me the most reasonable insurance. Any takers?

My suggestion - budget something like $500/mo/person. Half for insurance and half for saving in the HSA. As a freelancer you'll likely make too much money to have any of your insurance covered by the government. It's outrageously expensive, but if you have serious health problems, a $12.7k deductible is way less than potentially ten times that in hospital bills.

As an aside - I do believe the AHA did some good. I had friends in states without a non-profit insurance provider like BCBS who simply could not leave their jobs due to pre-existing conditions. That no longer happens, thankfully. However - we can do better. It's insane that I have to weigh the monetary cost of going to the doctor in my decision to go. Of course we all go for an acute illness, but I believe there are millions with minor chronic illness that are simply not getting treated because they cost of even the most common diagnostic tests is astronomical.

Some areas of the country seem to have been better served with the passage of ACA, but much of NC seems in the dark ages. I think we've got one other company that's now serving our county this year, and they're ... 20% more expensive, IIRC.

If he has a healthy family who does not need coverage outside of basic physicals, then its likely he purchased this plan to only cover catastrophic events, I know I would rather purchase the $500/m with 23k deductible rather then the $1000/m 13k deductible if I only planned on using coverage in the event of a horrible catastrophe.