Good medical insurance not from a job?

[RandomEvent]

While I have great medical and all around benefits working at Bank of America, my sister is turning 21 soon and isn't too sure on what she's going to do for insurance.

At first I told her to discuss it with her boyfriend, but while he's a nice guy, he certainly has never even contemplated words like, "leader, initiative, preparation, insurance, life security, common sense about living life as an adult... etc." So that's useless. I'm hoping someone here can give me some information or experiences with medical insurance providers that aren't job/company related. From what I can understand, money isn't a big issue for my sister, but I would say the cheaper the better (even though I know it's expensive as heck).

Thank you in advance for your help.

[Stu L.]

I was worried you were in Texas The average is something like 41% of us don't have any medical insurance.

I would encourage her to contact some local insurance agency's. If it's a non-captive agency, they can represent a number of medical insurers and she would have more options.

Does she work, or is she looking for a career? Is she's been healthy, I would suggest she look into a HSA health plan. If she needs ongoing meds (asthma, etc) then a traditional PPO should cover her.

[RandomEvent]

Thanks for the info. As for work, I assume she will have a career someday. She's a stay at home mother right now. A PPO would probably be best, it seems. Any other advice?

[Stu L.]

Probably then a PPO would be best. Will the kiddo be in on it as well? Most carriers have free or reduced cost immunizations for kids. And tell her to try and find a balance between monthly payment and deductable.

[RandomEvent]

What do you mean by find a balance? As in, they should balance, or what the actual balance is?

[Stu L.]

Right, they should find a balance between monthly premium payment and deductable. All too often people will double their deductable to save $20 a month on payments. Well, when you have to go to the hospital, you have to come up with that much more money to meet your deductable.

For example, a $2500 plan may cost $X+$20 a month. But, a $5000 plan just costs $X. Sounds great now, but when you need it...

[disenchant]

Well, I DID have luck with Unicare (www.unicare.com). They had a good major medical plan. It involved a high deductable (you can choose) but it also gave 2 doctor's visits a year covered and a prescription plan. They were good when I was out of work and freelancing.

They were good to me once, but sucky to me the last time I tried to get coverage for 1 month between insurance plans. The lady signed me up for September month instead of August like I wanted. My new insurance kicked-in in September. I was stupid and didn't catch the mistake until my insurance card came in the mail and then when I called to get it changed or a refund I was told I couldn't even though it was her mistake and I kept saying if they referred to the recorded phone conversation I was saying I needed coverage for August. I was stuck with double coverage for one month and no coverage for August.

Getting major medical in case of a bad accident is better than nothing. Good health insurance that covers everything can be up to $500 a month or more. Not worth it if you're young and trying to make it on your own! You're better off paying out of pocket for the small expenses if they occur and getting covered in case of a catastrophe. The goal is to play the risk game until you can get a job to get regular insurance.

I'd recommend Unicare even though they screwed me over. I take part of the blame for not double-checking the numbers and assuming that the person doing the signing up knew what she was doing. I should know better!

[RandomEvent]

Ok, I see. Now here's another question, everyone. I know about deductibles, but someone once told me that certain plans don't require you to fully pay your deductible before the insurance coverage can kick in. I'm not sure this is true. But anyway, if it isn't, and my sister finds a decent plan with a 2500 dollar deductible. Does you have to cover the deductible for EVERYTHING (medicine, emergency, etc) before the insurance plans start covering you?

[Stu L.]

Originally Posted by RandomEvent

Ok, I see. Now here's another question, everyone. I know about deductibles, but someone once told me that certain plans don't require you to fully pay your deductible before the insurance coverage can kick in. I'm not sure this is true. But anyway, if it isn't, and my sister finds a decent plan with a 2500 dollar deductible. Does you have to cover the deductible for EVERYTHING (medicine, emergency, etc) before the insurance plans start covering you?

With the ones I have, there are plenty of plans that offer benefits before the deductible is met, through copays. It depends on the plan she purchases.

[RandomEvent]

Ok, thanks a lot. I've been looking through this stuff, and I'm not sure if she should actively seek an agent, or do it online. She doesn't have much time to leave her house these days, so online might be better. I'll bring the MacBook over to her place so she can look for medical plans. Thank you again for all of your help.

PS: If anyone else wants to chime in, please do. But Stu and disenchant have already been a huge help to me.

[disenchant]

Originally Posted by RandomEvent

Ok, I see. Now here's another question, everyone. I know about deductibles, but someone once told me that certain plans don't require you to fully pay your deductible before the insurance coverage can kick in. I'm not sure this is true. But anyway, if it isn't, and my sister finds a decent plan with a 2500 dollar deductible. Does you have to cover the deductible for EVERYTHING (medicine, emergency, etc) before the insurance plans start covering you?

The Unicare plan I was on gave 2 doctor's visits a year that were covered with a copay. 2 visits a year was enough for my yearly girlie appt. and one other if I was sick. There was a list of network doctors though.

There wasn't a deductible for generic prescriptions, I believe they were $10. I did the $2500 deductible because it gave me the lowest monthly payment and I really only wanted the insurance for medical emergencies. Having researched different plans, it was the best way to go because insurance is EXPENSIVE. For $500 a month I might as well just sock the money in a bank account and use it to pay for the small medical expenses I might have.

Good luck!

[Stu L.]

Hey, for a Jericholic...

I still say call an agent. They can help answer any direct questions, and suggest plans based on her needs.