I Need help on Finding Health Insurance for a Couple

[TampaHound]

I generally don't do health plans. However this fell into my lap and I know I need a bit more info.


Florida couple, he's 60 and she's 61. Both are in "reasonable good health" and still working They are both self employed (and do well for themselves) They have Blue Cross/Shield and are paying #3350/mn for coverage.

I am hoping to find a company for them ASAP and would provide them with similar coverage to what they have now (I know, I need that info too).

Any ideas to point me in the right direction?

 

[KennyWest]

I generally don't do health plans. However this fell into my lap and I know I need a bit more info.


Florida couple, he's 64 and she's 60. Both are in "reasonable good health" and still working They are both self employed (and do well for themselves) They have Blue Cross/Shield and are paying #3350/mn for coverage.

I am hoping to find a company for them ASAP and would provide them with similar coverage to what they have now (I know, I need that info too).

Any ideas to point me in the right direction?

PM'd you contact info for a guy in Florida

 

[FLM2]

I generally don't do health plans. However this fell into my lap and I know I need a bit more info.


Florida couple, he's 64 and she's 60. Both are in "reasonable good health" and still working They are both self employed (and do well for themselves) They have Blue Cross/Shield and are paying #3350/mn for coverage.

I am hoping to find a company for them ASAP and would provide them with similar coverage to what they have now (I know, I need that info too).

Any ideas to point me in the right direction?

It really depends on the county they live, many are Florida Blue exclusive in 2017. If they have Blue Options there are some reasonable, less expensive POS alternatives with AvMed in a few counties, other than that there is nothing other than HMOs with crappy networks

 

[TampaHound]

In the conversation I had with them earlier tonight I found out a few more things.

1) The ages were wrong. He's 60 and she is 61.
2) He's a cancer survivor going on 4 years with once a year followup
3) He takes Warfarin for a Factor 5 deficiency (I had to look that up - clotting disorder).
4) He's also on Statins for HCL (who isn't?)


His wife has no medication or issues.

Jacksonville area.

They even suggested they would be OK with just having catastrophic coverage for the next few years till they are eligible for Medicare. I'm iffy about that but understand the reasoning.

Thoughts?

 

[FLM2]

In the conversation I had with them earlier tonight I found out a few more things.

1) The ages were wrong. He's 60 and she is 61.
2) He's a cancer survivor going on 4 years with once a year followup
3) He takes Warfarin for a Factor 5 deficiency (I had to look that up - clotting disorder).
4) He's also on Statins for HCL (who isn't?)


His wife has no medication or issues.

Jacksonville area.

They even suggested they would be OK with just having catastrophic coverage for the next few years till they are eligible for Medicare. I'm iffy about that but understand the reasoning.

Thoughts?

No such thing as Catastrophic, just crappy Bronze plans with $7K deductibles.

AvMed Empower Bronze with copays for them in Duval County, $1568 per month.

This is a good POS but doesn't cover Mayo Clinic, it should have all of the other hospitals in the area.

If both you and they are interested PM me, I can help them pretty easily.

None of the health issues mean anything since it's all guaranteed issue, just a matter of checking the drug formulary

 

[gregj]

If as OP mentions, the couple's "doing pretty well" financially, & their health is stable-ish, one/both of them should consider opting for HSA-compatible options which are available in Jacksonville for ~$500/month. Depending on Rx, each can choose different options to suit their individual situation - again, fairly easy to run the comparisons.

Not sure why this route wasn't suggested by previous posters

 

[tonyisme]

Be very careful moving a cancer survivor. His older plan is better than the newer ones.
Moving a sick person could spell disaster

 

[kenzy20]

I generally don't do health plans. However this fell into my lap and I know I need a bit more info.


Florida couple, he's 60 and she's 61. Both are in "reasonable good health" and still working They are both self employed (and do well for themselves) They have Blue Cross/Shield and are paying #3350/mn for coverage.

I am hoping to find a company for them ASAP and would provide them with similar coverage to what they have now (I know, I need that info too).

Any ideas to point me in the right direction?

Hey feel free to shoot me an email! over $3000?! Thats insane! I do calling for an agent and get information to create quotes and if they qualified i guarentee a premium though us would be half that price or even a lot less!

 

[junkman]

HSAs are almost always the best option for those that are self employed and paying the full premium. They are sick and have money so, buy them a broad network PPO HSA. They probably are best off with the highest OOP available.

If one of them expects to meet the OOP in 2017, consider a lower OOP but you have to do the calculations. I only consider network, OOP and premium in cases like you describe.

If they sty out of the hospital, they won't hit the OOP and get to save premium dollars. If they have something expensive planned, it may make sense to buy a lower OOP for the one who needs work. The other should buy the highest OOP possible. Lok at incremental cost and OOP between the 2 plans.

The self employed are always looking for tax deductions and nothing is better than an HSA. Besides, copays are some of the most expensive claim dollars you'll ever buy.

If they can get BCBS, the plan B07S is the lowest premium plan available in most areas. You don't want a narrower network than the S.