How to Choose Health Insurance – Startup Edition • Hacker News Board

Re: How to Choose Health Insurance – Startup Edition

#51

Post by secabeen » Tue, Nov 20, 2012, 12:44 AM UTC

rdl wrote: post #48

Stratoscope wrote: post #36

Here's a bit of info about HSAs (Health Savings Accounts) since there are a few questions about them. In particular I'll contrast them with FSAs: Like an FSA, pre-tax money goes into an HSA, and you can withdraw from it tax-free for qualifying medical expenses. You can also make taxable withdrawals with no penalty for non-medical purposes after age 65. Unlike an FSA, an HSA is a real savings account and not a use-it-…

The annoying trick once you have an HSA is that you basically need to put $3k balance into it to keep from paying recurring fees on a decent savings account (HSA or Sterling, I think), or you have to have over a certain amount to then be allowed to use it to either buy funds (often overpriced) or do self-directed trading (also usually on subpar terms). It's essentially a Roth IRA; it actually makes sense, due to comp…

Another thing that can be annoying about HSAs is that they also have account closure fees. If you're going to shut down your HSA, make sure you drain it to $0 before you call to close it out. I lost $15 that way.

Re: How to Choose Health Insurance – Startup Edition

#52

Post by twoodfin » Tue, Nov 20, 2012, 1:47 AM UTC

rayiner wrote: post #35

twoodfin wrote: post #21

Earlier quoted context omitted.

The U.S. has public education, and people still worry an awful lot about whether their kids' schools are any good, to the point of some spending a premium of literally hundreds of thousands of dollars on housing in the "right" districts, or on private education. The poor are still underserved, racially-measured outcome disparities are substantial, etc. None of this is directly an argument against public health care,…

When you adjust for demographics, American education is as good as any system in western Europe, and by and large middle of the spectrum families can be assured that their local public school will at least not be a complete disaster. The same isn't true for healthcare. This bizarre system of tying your healthcare to your job means even middle and high income families don't have any peace of mind when it comes to heal…

If you don't mind my asking, what's your health plan? I'm on a Blue Cross Blue Shield of MA PPO and couldn't be happier. It's indeed very expensive, but considering what my family has gotten out of it with essentially 0 hassles, I have no grounds for complaint. Essentially everything's covered, even out to some wacky stuff like acupuncture. I can walk into a specialist's office at a world class hospital with no referral for a $20 copay. During at least two health crises, they've reached out to make sure care was being coordinated properly.

Sorry that this sounds like an ad, but we don't all live in fear of our health plans. (I dislike the term "insurer", since what they sell stopped behaving like insurance a long time ago.)

Re: How to Choose Health Insurance – Startup Edition

#53

Post by astrodust » Tue, Nov 20, 2012, 3:08 AM UTC

twoodfin wrote: post #52

rayiner wrote: post #35

Earlier quoted context omitted.

When you adjust for demographics, American education is as good as any system in western Europe, and by and large middle of the spectrum families can be assured that their local public school will at least not be a complete disaster. The same isn't true for healthcare. This bizarre system of tying your healthcare to your job means even middle and high income families don't have any peace of mind when it comes to heal…

If you don't mind my asking, what's your health plan? I'm on a Blue Cross Blue Shield of MA PPO and couldn't be happier. It's indeed very expensive, but considering what my family has gotten out of it with essentially 0 hassles, I have no grounds for complaint. Essentially everything's covered, even out to some wacky stuff like acupuncture. I can walk into a specialist's office at a world class hospital with no refer…

What does "very expensive" mean in this context?

Re: How to Choose Health Insurance – Startup Edition

#54

Post by astrodust » Tue, Nov 20, 2012, 3:11 AM UTC

thezoid wrote: post #19

jeffreylo wrote: post #4

Earlier quoted context omitted.

This article's clearly written for the state of California. Did you read the article?

It's nice to not have to worry about these things though. It would be pretty awesome to one day see the US have a public health care.

Of all the hassles founders and workers in small start-ups have, worrying about affording your health insurance is insane.

Re: How to Choose Health Insurance – Startup Edition

#55

Post by khuey » Tue, Nov 20, 2012, 3:45 AM UTC

jpdoctor wrote: post #24

helmut_hed wrote: post #14

I'm curious to know, for the "Ongoing Medical Conditions" case, whether they verified if you could actually get insured in the first place on the plans they recommended. This seems to be the biggest issue with private insurance - they don't have to take you, and generally won't, if you have a "preexisting condition" of any sort.

This. Also: Going with some mickey mouse plan is essentially a bet that you'll never be diagnosed with anything that is chronic during coverage. My wife manage to strike it rich with an autoimmune disease, and now we essentially cannot move nor change plans in any way. (ACA will help a lot, but I still wouldn't put it past the assholes in DC to repeal it before it helps us.)

Now that Barack Obama has been reelected there's no way the ACA is getting repealed before January 2017 (he's not going to let his signature accomplishment get repealed, and there's no way Republicans will amass a veto-proof majority in the legislature). After that, it likely will be too entrenched to repeal wholesale.

Re: How to Choose Health Insurance – Startup Edition

#56

Post by twoodfin » Tue, Nov 20, 2012, 5:18 AM UTC

astrodust wrote: post #53

twoodfin wrote: post #52

Earlier quoted context omitted.

If you don't mind my asking, what's your health plan? I'm on a Blue Cross Blue Shield of MA PPO and couldn't be happier. It's indeed very expensive, but considering what my family has gotten out of it with essentially 0 hassles, I have no grounds for complaint. Essentially everything's covered, even out to some wacky stuff like acupuncture. I can walk into a specialist's office at a world class hospital with no refer…

What does "very expensive" mean in this context?

Don't quote me, but something like $1000/month for employee +1 coverage. Of that, ~30% comes out of my paycheck and is tax deductible. Not to put too fine a point on it: $300/mo pretax is a steal. Even assuming the full cost would, IMHO, be reasonable. $12,000 sounds like a lot but I suspect that BCBS is doing more for me in real terms right now than the Federal government to which I hand over the equivalent of a mid-range Mercedes in income tax every year.

Re: How to Choose Health Insurance – Startup Edition

#57

Post by astrodust » Tue, Nov 20, 2012, 5:43 AM UTC

twoodfin wrote: post #56

astrodust wrote: post #53

Earlier quoted context omitted.

What does "very expensive" mean in this context?

Don't quote me, but something like $1000/month for employee +1 coverage. Of that, ~30% comes out of my paycheck and is tax deductible. Not to put too fine a point on it: $300/mo pretax is a steal. Even assuming the full cost would, IMHO, be reasonable. $12,000 sounds like a lot but I suspect that BCBS is doing more for me in real terms right now than the Federal government to which I hand over the equivalent of a mid…

It doesn't just sound like a lot. It is a lot.

Even with the "high income" surcharge here for health-care, it's less than $1000 a year for an individual. Since it's deducted from your income along with regular payroll taxes, you don't even have to pay for dependents. They're covered under their own plan which is basically free until they start earning and paying deductions of their own.

In a start-up environment, $12,000 a year is not a lease on a Mercedes, it's the difference between your business floundering in obscurity and affording a few key networking trips, or the difference between living in a bedbug infested hellhole or having a decent apartment.

Re: How to Choose Health Insurance – Startup Edition

#58

Post by twoodfin » Tue, Nov 20, 2012, 6:55 AM UTC

astrodust wrote: post #57

twoodfin wrote: post #56

Earlier quoted context omitted.

Don't quote me, but something like $1000/month for employee +1 coverage. Of that, ~30% comes out of my paycheck and is tax deductible. Not to put too fine a point on it: $300/mo pretax is a steal. Even assuming the full cost would, IMHO, be reasonable. $12,000 sounds like a lot but I suspect that BCBS is doing more for me in real terms right now than the Federal government to which I hand over the equivalent of a mid…

It doesn't just sound like a lot. It is a lot. Even with the "high income" surcharge here for health-care, it's less than $1000 a year for an individual. Since it's deducted from your income along with regular payroll taxes, you don't even have to pay for dependents. They're covered under their own plan which is basically free until they start earning and paying deductions of their own. In a start-up environment, $12…

Where's "here"?

Re: How to Choose Health Insurance – Startup Edition

#59

Post by kochbeck » Tue, Nov 20, 2012, 7:05 AM UTC

Umm... that was a pile of mediocre advice. They compared a bunch of plans to costs in San Francisco, but they overlooked the #1 most important thing: for persons with fairly low to zero income, San Francisco already has universal healthcare. For founders, the care is actually pretty good, and the premiums are very low for end-to-end primary, emergency, hospital and prescription coverage. I've used it. No major complaints.

The program is called Healthy SF. If you're presently living in SF and not covered, check the enrollment site and get registered right away.

Re: How to Choose Health Insurance – Startup Edition

#60

Post by astrodust » Tue, Nov 20, 2012, 8:27 AM UTC

twoodfin wrote: post #58

astrodust wrote: post #57

Earlier quoted context omitted.

It doesn't just sound like a lot. It is a lot. Even with the "high income" surcharge here for health-care, it's less than $1000 a year for an individual. Since it's deducted from your income along with regular payroll taxes, you don't even have to pay for dependents. They're covered under their own plan which is basically free until they start earning and paying deductions of their own. In a start-up environment, $12…

Where's "here"?

Here meaning Ontario: http://en.wikipedia.org/wiki/Ontario_Health_Insurance_Plan

There are private insurance plans for exceptional circumstances, but these often over-lap with other policies to such a degree they're basically a luxury offered by companies to entice workers. The only real perk to them is the dental and optical coverage that isn't covered by the standard health-care system.