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Advice on private health insurance for equine professionals?

Off Course
#1

I am at the age where I am getting kicked off of my parents’ insurance. I am a riding instructor and I am not offered health insurance by the farm I work for. I’ve started to look for information online, and I’m totally overwhelmed. I had back surgery in December for a horse-related injury, so clearly I need good coverage. But, as someone who is building my program, I don’t have a ton of money to spend every month. COBRA is totally out of reach financially, as is my parents’ health insurance conversion plan.

Can those of you who are equine professionals and purchase private insurance offer me any advice or tips? I hear that sometimes there are professional organizations that offer discounts on health insurance. Do any of these exist in our industry? Any info would be appreciated!

#2

Nevermind, fixed the title. Thanks LauraKY. :wink:

#3

Go into edit, advanced and change the title. I have no advice. My daughter has a conversion policy and was lucky to get it when she did (big pre-existing condition). Vote for Obama and Democrat ticket. That’s the best advice I can give, I’m afraid.

#4

There is a reason millions of americans don’t have health insurance. Affordable coverage, by and large, does not exist. Women are nearly 2x as much to insure as a man because we have a uterus.

When I was looking some years ago (c 2004/2005) I called USAA and asked what they could offer. Major coverage only, no perscription coverage, no preexistings, no red flags. Something around $400/mnth. This would have covered catastrophic illness (cancer) but not a broken leg.

Are you self-employed or are you an employee? You said the farm doesn’t offer insurance, so I’m not clear on what your exact status is.

If you are self-employed, start with your state small business association or whatever they offer. In some states there are “pools” that small businesses can buy into.

Start calling every reputable agent you can find and ask them what products the companies they represent offer someone in your situation. If you are USAA eligible, call USAA. There may be other regional options for you as well. This is all MUCH easier if you use an agent to help you translate the products for you.

Do you make (not) enough to quality for your state’s Medicaid/Medicare thresholds? You might be surprised at how high those limits are.

Just start calling. And always remember: there is a reason this is such a hot political issue. Individual coverage is EXPENSIVE and frequently LOUSY. There is a reason millions and millions of Americans do NOT have coverage.

#5

I am an independent contractor. I should have made that more clear in my first post, sorry.

#6

Bite the bullet and go with the conversion plan. You have a number of issues going against you. First, you have a serious enough pre-existing condition that coverage is going to be excluded for your back issues for a period of time. So even is you can find coverage elswhere, of you hurt your back in the interim – tough luck. Fortunately under HIPAA, if the health insurer considers you an non-standard risk, you still can get coverage but the premium will be much higher.

As a riding instructor, you have a reasonable risk of getting on an the job injury. Looks like the farm is cutting corners by calling you an IC when you are an employee to avoid employer taxes and workers comp. So if you want to stay in this profession, I suggest at least finding a job where you are an employee and get workers comp if you are hurt on the job.

I would seriously consider your career path if getting health insurance is problematic. Something very minor can destroy you financially if you are uninsured. You need to think about that.

#7

I was told by my insurer that with a certification of health care coverage (something along these lines?) letter, private insurers would have to accept my pre-existing conditions for 60 days following the termination of my parents’ health insurance coverage. Does anyone know if this is actually the case?

The conversion plan is something like 800 a month and COBRA is around 600. I literally don’t have the money to pay for that. A quote for moderate deductible private insurance is around 1/4 of what COBRA costs, however they haven’t seen my medical records about my back yet.

Yikes. This is not going to be fun. Thanks for all the information you’ve provided so far, everyone.

#8

I have Blue Shield! It’s basically a catastrophic plan with fairly high deductibles, but they cover some basic preventative care and if I have a bad accident it’s better to have to pay a couple thousand in deductible than 10’s of thousands! It’s very affordable, only $122/month!

#9

My apologies, but unfortunately the only info I can offer is that living without insurance may be something you have to learn to deal with.

If you really feel you HAVE TO have it then I would recommend finding some arrangement to eliminate/reduce housing costs as low as possible. Can you move in with a friend for a very nominal cost? Can you rent a room instead of an apartment? Network with the folks at the tack store and any other industry professionals you can think of (vets, farriers, grooms, etc) to find a way to live for super cheap, so you can squeeze out the $ for health insurance.

Don’t be shy. These other industry professionals understand the situation, and they are likely your best resource to find super cheap housing that would allow you to splurge on a health insurance plan that will actually be worth the amount you are paying out each month. There is no point in paying for health insurance if they are not going to actually cover anything !!

But really, horse industry professionals largely have to deal with being uninsured. I don’t qualify for state coverage in my state, NJ. (I have to be in a ‘family way’ or over 65.)

#10

Check out group health. Not having maternity coverage ended up being an issue when my little surprise showed up, but it’s affordable and at leadt covers the basics.

#11

[QUOTE=jennywho;6277434]
Check out group health. Not having maternity coverage ended up being an issue when my little surprise showed up, but it’s affordable and at leadt covers the basics.[/QUOTE]

GroupHealth (if we’re talking about the same company) only provides coverage in a few states.

Which drives home the point about the OP has to do a lot of legwork, because this can vary SO dramatically from state to state to state. Some carriers only operate in some states, some states offer various programs, other states have other mandated things insurers MUST cover or % covered… so on and so forth. Even a national carrier like BC/BS is going to offer different products in different regions.

But I think the OP is going to be in the grim, horrible place as what… 35 million other Americans are in?

#12

I would look online and get some quotes in your state. An insurance broker who is familiar with your state would be helpful. Insurance is easily available in general, but it may be more difficult to get your pre-existing condition covered. good luck!

#13

Can you get a policy with the same company your parents are with? Perhaps they will/must cover your pre-existing condition because you are already insured with them?

#14

I am an IC myself. I carry Anthem BCBS. I pay 180.00 and have a 1500.00 deductable. It is 80/20 ,so I am still responsible for 20% of my bill.However there is a co pay of 30.00 on the first 4 doctors visits.Also if you are paying for stuff while still trying to meet your deductable,the cost of what Dr.s bill you for is lower if you have insurance than if you don’t . You are much younger than I am so ,the cost may be less for you.Anthem is accepted by most of the Drs. ,at least in Va. I havehad 2 significant injuries in the last 3 years ,so it was nice to have the coverage. They also have a prescription plan. And FYI ,if ,God forbid, you get injured and run up a hosptial bill,be sure to negotiate with the hospital on payment.If you don’t make a lot of money they will reduce your bill and work out payments for you.

#15

Yes, the 60-day window (it’s actually a tiny bit longer) is HIPAA. Any health plan you apply to MUST accept you with the HIPPA letter, however they don’t have to offer you a standard rate. Trust me, once they see the pre-ex you have – the rates are going to go through the roof because of the HIPAA coverage OR perhaps you can have it excluded as a pre-ex if you waive HIPAA. I would NOT recommend that latter given your job.

Personally, ask Mom and Dad if they can help subsidize the insurance until you get it sorted out. I have seen way too many people bankrupted by fairly minor health care issues when they have no insurance. It doesn’t take long to run up thousands of dollars in bills. If you have an existing back problem, it’s not even a question of it, it’s a question of when.

And seriously, look at finding a job that at least provides worker’s comp. There are barns out there that are willing to pay taxes for employees and provide worker’s comp. Among other things, they know having even these most basic “benefits” makes them able to attract and retain the best people.

And as LauraKY says, hope that the Patient Protection and Affordability Act survives the Supreme Court. We need serious health care reform in this country and while this law is not perfect, it improves availability and affordability for many people.

#16

It’s a horrible problem for millions of Americans. Lets all hope that the Supremes do not shoot down Obamacare, that’s the absolute best solution anyone has come up with so far to this awful problem. Under that law you cannot be turned down for a pre-existing condition.

I personally have friends who cannot afford insurance. And they are in their 50s. I’d recommend getting insurance any way you can rather than going without.

#17

I know that for a time my brother had a cheap insurance policy called Golden Rule. He had no prior health issues and luckily did not have to use the insurance while he had it, so that’s about all I can tell you. Good luck! :frowning: :slight_smile:

#18

I wanted to add my thoughts. This is the first time IN MY LIFE I have no health insurance because of the expense. I have been underemployed for over 4 years and am currently unemployed (I just recently moved). If you have any pre-existing conditions, the “teaser” rates that they rein you in with will double, triple, even quadruple. I am a fairly healthy middle aged woman with no chance of any more pregnancies. I have never smoked at all either.

Check with insurance brokers to hopefully find the best rate/company for you, but be forewarned it will be very, very expensive!

#19

I work for a national health insurance company and I will say that private, stand alone policies are generally prohibitively expensive. Types of coverage and the companies available to provide coverage to you will vary by state. Your first step in finding affordable coverage would be to contact your state department of health to see if they have any subsidized plans. If they don’t have any that you qualify for, try looking into an SBA in your area. Often times, they have group coverages available for those who might be, like you, an independent contractor or sole proprietor. It would be well worth the membership fee to be able to take advantage of a group rate plan. Make sure whatever you sign up for is a creditable coverage. Don’t get roped into one of those discount plans that’s not really “insurance” because when you go to transition into a HMO/PPO/CDHP coverage that discount plan wouldn’t be creditable and you would have pre-existing on your policy if your new plan has that clause.

#20

Try: http://www.progressive.com/health-insurance/health.aspx

You can buy your own policy and in my experience when calling to ask questions the reps know their products.

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