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At the risk of this sounding like a thinkfluencer thread, I want to share my "consumer journey" of shopping for my own health insurance.
TL;DR: it's incredibly confusing and the cost is ridiculous.
My journey started when I was laid off in May...
TL;DR: it's incredibly confusing and the cost is ridiculous.
My journey started when I was laid off in May...
... my former employer was gracious enough to extend healthcare coverage for a few months. That time is winding down.
Time to go shopping.
I have a One Medical membership, which I love, and they confirmed that they take 4 types of insurance available in the Marketplace.
Time to go shopping.
I have a One Medical membership, which I love, and they confirmed that they take 4 types of insurance available in the Marketplace.
Why do I love One Medical? Because they are what a visit to the doctor *should* feel like: non-clinical offices, digital scheduling, ability to directly message my doctor, etc.
Most importantly in a time of pandemic, 1-day turnaround for Covid-19 tests. One Medical uses Labcorp.
Most importantly in a time of pandemic, 1-day turnaround for Covid-19 tests. One Medical uses Labcorp.
Back to shopping.
The NYS Marketplace website is something out of the early 00s. It is clunky, it logs me out randomly, and it just feels... like not great UX/UI
I've never had to buy my own health insurance before, so everything is confusing. I log off.
The NYS Marketplace website is something out of the early 00s. It is clunky, it logs me out randomly, and it just feels... like not great UX/UI
I've never had to buy my own health insurance before, so everything is confusing. I log off.
Oscar is one of the plans accepted by One Medical. Great! It's that DTC-feeling brand that has ads in the subway!
Their website is friendly & it makes a real attempt at explaining services and coverage.
The prices aren't cheap, but way better than COBRA (which is $$$$$).
Their website is friendly & it makes a real attempt at explaining services and coverage.
The prices aren't cheap, but way better than COBRA (which is $$$$$).
Here's a way to dimensionalize the cost:
Employers subsidize ~80% of the cost of a monthly insurance premium, so employee out of pocket is relatively low. Couple of hundred / month.
When you're on your own, you have to pay 100% of that. All of the sudden that $ becomes $$$$$.
Employers subsidize ~80% of the cost of a monthly insurance premium, so employee out of pocket is relatively low. Couple of hundred / month.
When you're on your own, you have to pay 100% of that. All of the sudden that $ becomes $$$$$.
I have Qs about when I should enroll, bc that's confusing as well. NYS extended it's emergency open enrollment to 8/15, my insurance runs out at the end of this month, general open enrollment starts on Nov 1... deadlines on deadlines.
So I call Oscar to get clarity.
So I call Oscar to get clarity.
Oscar CS is v friendly. I explain my situation with One Medical, with the deadlines, and how important Covid-19 testing is to me bc I will likely be traveling over the next couple of months.
Red flag. Oscar says Labcorp is out of network, and I must ask One Medical to use Quest.
Red flag. Oscar says Labcorp is out of network, and I must ask One Medical to use Quest.
The One Medical / Labcorp relationship is what is responsible for 1-day results.
I explain that to Oscar and express my concern that the 10+ day test results (via Quest, etc) that others are experiencing are a major concern for me.
They understand, but it's the rule.
I explain that to Oscar and express my concern that the 10+ day test results (via Quest, etc) that others are experiencing are a major concern for me.
They understand, but it's the rule.
Moreover, w/ my current insurance + One Medical, I can schedule a test and walk into a facility and get it done.
With Oscar, I'd need a referral by my doctor to get a test. I'd need to do this in person, bc they are unable to refer via their telemedicine service.
With Oscar, I'd need a referral by my doctor to get a test. I'd need to do this in person, bc they are unable to refer via their telemedicine service.
Then we talk about lab costs. High deductible health insurance plans usually don't cover lab costs, so they are $$ out of pocket.
Some types of insurance waive all Covid-19 test costs, including lab work. But not Oscar. Not only do they require Quest, but it's out of pocket.
Some types of insurance waive all Covid-19 test costs, including lab work. But not Oscar. Not only do they require Quest, but it's out of pocket.
So just to get this straight: a "reasonably" priced lower-tier plan at Oscar is ~$550/month with a super high deductible and high out of pocket max.
So to take a Covid test, I'd need to pay for a doctor visit, then pay for the lab processing.
It also would cost me extra time.
So to take a Covid test, I'd need to pay for a doctor visit, then pay for the lab processing.
It also would cost me extra time.
I want to reiterate how helpful Oscar was in explaining this to me. I don't want to kill the messenger. But these are the rules.
The way it is all set up literally disincentivizes me from taking tests and keeping myself and people who I care about safe.
The way it is all set up literally disincentivizes me from taking tests and keeping myself and people who I care about safe.
If I took two tests a month because of traveling, it could cost me >$1K/month (including premium) out of pocket. That's absolutely insane.
The system is incentivizing me to take as few tests as possible, unless I'm okay bleeding my savings account.
The system is incentivizing me to take as few tests as possible, unless I'm okay bleeding my savings account.
It took me about 2.5 hours today to find out all of this information, for just one potential provider. I could do the same 3 times over.
But I'm freelancing now and how I use my time during the day pays the bills, so I can't afford to spend hours with every other option.
But I'm freelancing now and how I use my time during the day pays the bills, so I can't afford to spend hours with every other option.
Net net, I am leaning towards extending my existing coverage via COBRA instead of using the Marketplace, because when Covid-19 is taken into consideration, it will likely cost me MORE.
I will now pay ~9x vs what I used to pay when I was full-time employed to have basic coverage.
I will now pay ~9x vs what I used to pay when I was full-time employed to have basic coverage.
The sad part is that I am actually really enjoying freelancing and would totally entertain starting my own biz, but health care costs and the reality of Covid is making it really difficult to justify.
The burden of high health care costs is killing that entrepreneurial drive.
The burden of high health care costs is killing that entrepreneurial drive.
To wrap it all up:
I've always believed in healthcare for all, but now I REALLY care about healthcare for all. I am not and will never be a single issue voter, but now that I've been through it, I swear I will scrutinize every politician's position on healthcare.
/end story
I've always believed in healthcare for all, but now I REALLY care about healthcare for all. I am not and will never be a single issue voter, but now that I've been through it, I swear I will scrutinize every politician's position on healthcare.
/end story
