I did exactly this as a freelancer even though not anymore. It will cost you more out of pocket to buy insurance compared to a "group" plan through an employer.
My first suggestion: Keep the health insurance through your wife if you can and if she is still working. It is hard to beat the plans sponsored by employers as they get subsidized group rates to offer to employees.
But if you absolutely need to buy your own, you have 2 options:
Option 1: Use Obamacare [0] and see your options. You can try healthsherpa.com [1] which is a unofficial wrapper on top of obamacare and you can compare the various plans.
Option 2: You go and buy health insurance directly from an insurance company without the extra layer of obamacare in between. You can use sites like ehealthinsurance [2] to get some quotes.
Option 3: Use an insurance broker. Find someone locally in your area. Sometimes brokers can get you good deals.
All options have benefits and problems. I personally hated obamacare as it was too much bureaucratic crap to deal with and now you have 2 layers to work with. The only advantage of obamacare is that if you are considered poor by obamacare standards, you can get subsidy on your premiums if you enroll through obamacare. But if you don't care about these things or are not applicable to you, then just go buy insurance directly and not even bother about obamacare.
Monthly Costs depend on a few factors:
In-network vs Out-Network: Very important factor. You can only go to certain doctors/hospitals etc that are "in-network". Some plans only allow in-network. Some plans have both but have higher premiums. Also, out of network coverage is very limited usually.
Co-Payment: This is the amount (usually $10-$30) that you will pay for every visit to a doctor. Some plans have no co-payment while most have the range as I mentioned.
Deductible: This is the amount that you will pay first for any medical expenses before your insurance company pays anything. So if you go for a plan with "high deductible", then your premiums may be lower and so on.. I will say that for a family specially with kids, I personally prefer zero deductible as it can save you more over a year since kids visit doctors frequently. But if you think you won't visit the doctors as much in a year, then go for high deductible. Again, just a choice and no right answer here.
Co-Insurance: This is the portion that you will pay after your insurance company has paid the remaining portion. For example, if your co-insurance is 30%, then the insurance company will pay the 70% for the medical expenses and you take care of the rest. Again, to get here, you will have met your deductible first.
Out of Pocket limit: This is the total amount you may pay for an entire year. Anything over this, the insurance company pays regardless. For example, lets say your deductible was $500, co-insurance 30% and out of pocket limit is $5000 for the family and you end up with a bill of 14,000 on your very first visit during a calendar year. In that case, you will pay upto the total of $5000 (including deductible+co-insurance) and insurance company will pay the remaining balance of $9000. After that, you will not pay anything for that whole year (except copays). Plans with higher out of pocket limit may have lower premiums by logic.
PCP (Primary Care Physician) required: THis may not affect cost but important factor to know. Some plans require you to choose a PCP and only use that PCP as your well, PCP. You have to let the comnpany know if you change PCP.
Specialist Referral required: Some plans require you to get referral from your PCP before you can visit a Specialist. This is critical as you cannot go to a specialist on your own in that case.
Hope this helps. Happy to give you more inputs if you need.
> The only advantage of obamacare is that if you cannot buy insurance yourself that easily with things like pre-existing conditions etc.
Medical underwriting is no longer a thing industry-wide and hasn't been since the beginning of 2014. No matter where you buy your plan, they will not ask about pre-existing conditions.
It's true that the only reason why you'd actually buy through an exchange is to get the subsidies, even if you don't it's worthwhile to check. They offer a pretty comprehensive survey of the companies that offer insurance in your state and roughly how much you'll pay, and you can go to those companies separately and check into their plans they don't offer on the exchange.
Another idea is to find a local insurance broker in your area. They're free to you (the insurance companies pay them) and they'll find you a good plan that fits your needs.
"The only advantage of obamacare is that if you cannot buy insurance yourself that easily with things like pre-existing conditions etc."
It has vastly improved the health care the poor receive.
I'm not a huge fan of Obamacare, but it is all he could get past the Rebublicans at the time. He tried to push for a sensable solution, but Republicans fought it. I am waiting for anyone to propose a better solution to Obamacare, but keep bill's core requirements.
As to what how for-profit insurance companies have explioted us, while blaming Obamacare; I hope there's a special place in hell for these heathens! In the original Obamacare bill there were measures that would limit rate increases, and out of pocket fees--the Republicans got rid of all of them. I recall them saying, 'Get ride of this language/requirement and we might pass it?"
What I am trying to say is get rid of Obamacare, but replace it with something better. I haven't heard any real alternative plans proposed by the Rebublicans? I though the the Rebublican Doctor(Bobby Jindal) would have a thoughtful, pragmatic plan--yea, he has a plan, but it just sounds like basically going back to the free market system we had before?
That worked so well?
I don't think what we had before could really be described as a "free market system". It was an employer-based healthcare system that shut individual buyers out of the only good deals, enacted by the government via the tax code.
The new system is the same, except now there's no pre-existing conditions and the individual is forced to buy a plan. The plans themselves are the same crappy plans with a few tweaks.
The consumer of healthcare is still completely disconnected from the price of the goods sold, completely screwing up market signals and making sure prices stay astronomically high. This is not a free market by any measure.
My first suggestion: Keep the health insurance through your wife if you can and if she is still working. It is hard to beat the plans sponsored by employers as they get subsidized group rates to offer to employees.
But if you absolutely need to buy your own, you have 2 options:
Option 1: Use Obamacare [0] and see your options. You can try healthsherpa.com [1] which is a unofficial wrapper on top of obamacare and you can compare the various plans.
Option 2: You go and buy health insurance directly from an insurance company without the extra layer of obamacare in between. You can use sites like ehealthinsurance [2] to get some quotes.
Option 3: Use an insurance broker. Find someone locally in your area. Sometimes brokers can get you good deals.
All options have benefits and problems. I personally hated obamacare as it was too much bureaucratic crap to deal with and now you have 2 layers to work with. The only advantage of obamacare is that if you are considered poor by obamacare standards, you can get subsidy on your premiums if you enroll through obamacare. But if you don't care about these things or are not applicable to you, then just go buy insurance directly and not even bother about obamacare.
Monthly Costs depend on a few factors:
In-network vs Out-Network: Very important factor. You can only go to certain doctors/hospitals etc that are "in-network". Some plans only allow in-network. Some plans have both but have higher premiums. Also, out of network coverage is very limited usually.
Co-Payment: This is the amount (usually $10-$30) that you will pay for every visit to a doctor. Some plans have no co-payment while most have the range as I mentioned.
Deductible: This is the amount that you will pay first for any medical expenses before your insurance company pays anything. So if you go for a plan with "high deductible", then your premiums may be lower and so on.. I will say that for a family specially with kids, I personally prefer zero deductible as it can save you more over a year since kids visit doctors frequently. But if you think you won't visit the doctors as much in a year, then go for high deductible. Again, just a choice and no right answer here.
Co-Insurance: This is the portion that you will pay after your insurance company has paid the remaining portion. For example, if your co-insurance is 30%, then the insurance company will pay the 70% for the medical expenses and you take care of the rest. Again, to get here, you will have met your deductible first.
Out of Pocket limit: This is the total amount you may pay for an entire year. Anything over this, the insurance company pays regardless. For example, lets say your deductible was $500, co-insurance 30% and out of pocket limit is $5000 for the family and you end up with a bill of 14,000 on your very first visit during a calendar year. In that case, you will pay upto the total of $5000 (including deductible+co-insurance) and insurance company will pay the remaining balance of $9000. After that, you will not pay anything for that whole year (except copays). Plans with higher out of pocket limit may have lower premiums by logic.
PCP (Primary Care Physician) required: THis may not affect cost but important factor to know. Some plans require you to choose a PCP and only use that PCP as your well, PCP. You have to let the comnpany know if you change PCP.
Specialist Referral required: Some plans require you to get referral from your PCP before you can visit a Specialist. This is critical as you cannot go to a specialist on your own in that case.
Hope this helps. Happy to give you more inputs if you need.
[0] https://www.healthcare.gov
[1] http://www.healthsherpa.com
[2] https://www.ehealthinsurance.com