Affordable health insurance for the family when self employed

A. The easy answer is take a $100,000 deductible. That would be very affordable. (A little sarcasm folks!) I like to answer that question with a shock, since it draws attention to the big flaw in how people approach buying health insurance. I find that most people focus only on premium as the way to control their healthcare costs. Self Employed people especially, need to focus on the combination of healthcare expenses and health insurance premiums.

The best way to control your healthcare costs is to start with an examination of your healthcare consumption and how you use insurance. The difference between the most expensive health insurance plan versus the lowest price might be 100% or a few hundred dollars a month. The difference to you between having your heart attack, stroke, gallbladder, or Hepatitis C covered, and at a preferred provider versus a non-preferred provider, could be $20,000, $30,000 or even $100,000 of difference.

• Examine your personal healthcare usage and tendencies. Approach the process with "value coverage" as the goal.
• Make sure that when you are shopping that you check that you get a PPO network that serves your "what-if scenario" needs. Even though you have out of network benefits with a health plan and an out of network limit out of pocket, those numbers have almost zero meaning in real life claims. If you are out of network, the limits apply to what is "covered" and what is "covered" will be limited.
• Check the price for a high deductible plan from the carrier without all the bells and whistles like copay's and then back in those benefits and lower deductible options to see what the incremental cost is. You may want an Rx card for the copay, but your medication might only be $30-$40 per month from a place like Drugstore.com, so why pay $50 per month for the drug copay.
• Ask if the copay, and read the brochure, to see if the copay covers lab work done at the doctor office visit, or if only the office visit part of the charge is covered under the copay. All copay's are not alike.
• Emergency Room - Don't confuse an accident benefit with an ER copay benefit.
• Find a knowledgeable agent - Tell him/her what your preexisting conditions are. Let him/her advise you on what carrier might be more lenient on the handling of your preexisting condition is.

Always keep in mind, especially healthy people, the best way to control costs is to recognize that health insurance is only a part of the cost. Ultimately we buy insurance to protect ourselves from the big claims, not the small ones. The time to find out how good your insurance is, is before you need to find out.

About the Author:

Mark Gurda is President of Castle Group Health Inc., located in Northbrook, IL. Castle Group Health has been a successful and prominent agency for over 15 years. The firm deals solely in health insurance products, and acts as an agent for the top carriers in over 25 states. A recognized and respected authority on individual and group insurance for firms with less than 300 employees, Mr. Gurda offers a very unique and blunt approach towards health insurance.

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