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Ask HN: How much does private health insurance cost you?
One of the big barriers in my mind of quiting my day job and going independent is that I'll be responsible for my own insurance, which is a cost I can't ignore.
To those of you that are independent, how much is your health insurance actually costing you?
- greggeter 4y ago
- austinpena 4y ago~$900 because my wife is pregnant.
- ppbjj 4y ago$230 medical, $13 dental. Med has a stupid-high OOP max. I have that set aside in an HSA but knock on wood I never get into a major medical emergency in the fall potentially being responsible for 2x that. Good luck, OP.
- jurmous 4y agoMaybe you should consider moving to Europe and benefit from a proper public healthcare system? But I must admit, the energy bills lately are no fun here… So maybe wait until all that mess is over.
- idkwhoiam 4y agoAlso from crazy high taxation, inflation, and soon to come energy rationing
- toomuchtodo 4y agoStill sounds preferable compared to the US to be honest (as a US citizen with a residency visa app pending with a Western European country). Note the respondent paying $1800/month for two 63 year olds, or folks spending $2k-$3k/month for a family. These costs are simply unsustainable. Europe will eventually get their energy situation resolved, sooner than the US will fix their healthcare situation.
- atemerev 4y agoWell here in Switzerland there isn't much difference.
- deleted 4y ago[deleted]
- deleted 4y ago[deleted]
- ceejayoz 4y agohttps://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm Public + private spending; the US spends $12k/person, the Swiss $7k. The US is roughly double or more than any other developed nation in per-capita healthcare spending.
- bequanna 4y agoGiven the defense crisis now on Europe’s doorstep your countries may soon have to drastically increase defense spending. Taxes in Euroland are already quite high. That money is going to have to come from somewhere and likely will eat into your public healthcare budgets.
- onion2k 4y agoTaxes in Euroland are already quite high. A quick google[1] reckons people on low incomes spend as much as 35% of their income on healthcare alone, before pay any taxes. You need to be earning a lot in Europe before you get even close to that. If you're on a low-to-average income then Europe is probably better. If you're rich then America is better. [1] https://www.advisory.com/daily-briefing/2019/05/02/health-care-costs https://www.advisory.com/daily-briefing/2019/05/02/health-ca...
- bequanna 4y ago> If you're on a low-to-average income then Europe is probably better. If you're rich then America is better. Many (most?) people on HN are highly-skilled, highly-paid technologists and likely the latter.
- lowercased 4y agoNot everyone can just move between countries. Beyond the cost and family/friends situation... the basics of immigration come in to play. Will that new country even allow you in? I'd looked in to this multiple times over the past couple decades, and it was often difficult or impossible short of having a few million behind you. In most cases, you'll need to have an actual employer-sponsorship lined up, and many employers in other countries are reluctant to bother. Not saying it doesn't happen, but it's not trivial to get those stars to line up.
- meerita 4y ago27€/Month.
- throwaway98797 4y ago$455/month keep in mind that PPOs for independents aren’t the same as PPOs for companies even though the appear to be. let’s say you have blue cross blue shield PPO with your current employer it’s not the same even on the platinum level blue cross blue shield PPO. fewer doctors in network. lots of mini surprises await you if you actually use it. that’s such bs. in a way i was personally better of prior to ACA since i could get insurance for $150/month. yes it’s nice that i can’t be disqualified due to pre existing conditions but it isn’t the meca it’s claimed to be.
- sparker72678 4y agoJust you? What’s your age? Any chronic health conditions? How risk tolerant are you?
- netman21 4y ago$1,800/month for two of us. Both 63 years old. In the US. Vision and dental extra.
- patja 4y agoOur high deductible insurance with Kaiser is about 12k/yr for a family of 3: two parents in their 50s and a teen. Then I max out an HSA (untaxed health savings account to actually pay for things) with about 7k, which generally gets drawn down to zero at some point over any 3 yr period. So I call it about 20k/yr all up.
- freedom2099 4y agoOMG… that is a lot!
- jonathanstrange 4y ago80 €/Month. It covers all kinds of doctor's visits, both general and specialists, hospital stays up to two weeks and, generally, grave illness until one million euro in cost/year. It also covers part of dental care but I still pay about 30 euros per session. It's in addition to my state health insurance which covers everything but requires going through more hoops.
- diegorbaquero 4y agoAround $56/mo in Colombia with access to top doctors, hospitals and clinics. Copay is $6 for any appointment. But surgery/ER/hospitalization incidents are free
- candiddevmike 4y agoIt doesn't matter how much it costs anyone because your circumstances and needs will be wildly different than others, and you may qualify for subsidies. I would figure out how much your current health insurance is (both the employee and employer contribution). This is the amount you would pay if you quit your job and went on COBRA. You can be on COBRA for 18 months and it's typically cheaper than finding an equivalent plan on the marketplace. That gives you time to grow your business and figure out a long term health insurance solution.
- matt_attack 4y agoI've found the opposite, though it likely depends on how "good" your insurance was. My COBRA was around $800/mo for a single person but that was essentially for a zero deductible plan. I could get reasonable short term plans for about a quarter of that. As a healthy individual that was definitely the right choice for me, but if you have high utilization already it might not be for you.
- beej71 4y agoBut also definitely comparison shop independent plans vs COBRA. COBRA can also be really expensive.
- lowercased 4y ago> COBRA can also be really expensive. But... it's not "expensive"... It's just the price. And many people never see or think about it because "employer" pays some/most/all of it. Until... you don't have an employer. Then it seems "expensive". But... the price has always been there, we just don't see it sometimes. Employer-involved insurance is one of the biggest things slowing social progress, imo.
- brian_herman 4y agoYou should go on healthcare.gov and look at plans. Insurance plans are variable from person to person and situation.
- e1g 4y agoNYC, $2,500/mo, two adults + one child. We're expecting our second child, and it'll increase to ~$3,200/mo. We're in our mid-30s, healthy (run marathons), non-smokers, with no prescriptions. Not having insurance means carrying the risk of going bankrupt after one unlucky event.
- sonthonax 4y agoHow does it feel to subsidise those who make poor health choices?
- swagasaurus-rex 4y agohow does it feel to subsidize greedy health insurance companies?
- e1g 4y agoThere is plenty of obscene profit generated in the US healthcare industry, but not within the insurance segment. Currently, health insurers are the only segment where profits (and “admin costs”) are directly capped via the ACA's MLR rules. The blame game should aim at the rest of the industry (e.g. hospitals, device manufacturers, pharmaceuticals).
- ceejayoz 4y ago> Currently, health insurers are the only segment where profits (and “admin costs”) are directly capped via the ACA's MLR rules. Capped at a percent of premium revenue, which gives them the perverse incentive to raise healthcare costs so their 20% maximum cut gets bigger.
- ceejayoz 4y agoEveryone on the planet, basically without exception (pedants: I'm not counting people in vegetative states, babies, etc.), makes poor health choices. You'd be like The Good Place's Doug Forcett, otherwise.
- kevingadd 4y agoAssume you may end up paying $500/mo for yourself in the US, or more. It gets worse as you age, and if you need a better plan (to control deductibles, etc) it'll cost you more. Last time I freelanced (at age ~28) it cost me about that much for a mediocre Kaiser plan in California.
- lowercased 4y ago> and if you need a better plan (to control deductibles, etc) I switched to an ACA marketplace plan this year, and... there are no caps for 'out of network' services. "Out of network" deductible is $35k/person. "Out of network" max "out of pocket" is "no max". Insane. And this is a $1100/month plan for 2 people.
- prirun 4y agoAccording to this, there is always a max: https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/ https://www.healthcare.gov/glossary/out-of-pocket-maximum-li... "For the 2022 plan year: The out-of-pocket limit for a Marketplace plan can’t be more than $8,700 for an individual and $17,400 for a family." However, above that it also says: "The out-of-pocket limit doesn't include: Costs above the allowed amount for a service that a provider may charge" The way this has always worked for me is that if the billed amount is $1000 and the max allowed amount is $600, then $600 is what is owed and the rest is "written off" by the provider. If I haven't met the max out-of-pocket yet, I pay first. Then insurance pays $600 - what I paid. But the way it is worded on the ACA page, it sounds like the provider can bill me directly for the $400 that was disallowed. That has never happened to me (Ambetter/MHS insurance in Indiana), and seems bizarre to have a max out-of-pocket that is not actually enforced.
- kevingadd 4y agoYou would basically need to appeal to your state health regulator if the insurer tries to pull stuff like that with you (they will). I had one insurer kick me off in violation of ACA policies and I had to appeal to California's regulator.
- mind-blight 4y ago$370 / month for Kaiser gold. 32, don't smoke, and no pre-existing conditions. Seeing the doctor costs me $50-$100 per visit. It's a bit depressing (but not surprising) to see any comment using dollars paying tons for limited service, and comments using euros pay a cut for everything
- technologia 4y agoHoly shit that copay is high, I had Kaiser too at one point and mine came out to $200ish a month with $20 copays. I know stuff varies but Kaiser felt like highway robbery
- giaour 4y agoIf you’re in the US, you can get some detailed quotes (and information on what tax benefits, if any, you may be eligible for) at healthcare.gov
- atemerev 4y ago$550/month for myself, $1100/month for my family (Switzerland, which has world's second most expensive healthcare, and insurance is obligatory for all, and only could be paid in after-tax money).
- hesdeadjim 4y agoCosts vary immensely if it’s just you ($), you and a spouse ($$$), or an entire family ($$$$$). As a point of reference, in 2015 I quit to go indie and decided to keep my employers coverage through COBRA. It cost me $1100 a month for my family. I rode it out until my wife got a job later that year, since we couldn’t find independent coverage anywhere as good as my former employer’s.
- myujinn 4y ago80€/month in France (+40€/month for my spouse, free for the kids), covers pretty much anything: hospital visits, general and specialists doctors, great vision and dental care. It is in addition to our social security system so that you don't have to spend anything (usually, there are exceptions) to get medical assistance.
- switch007 4y agoI believe my employer pays around £1,000 a year, which I think is a bit steep as it does not cover much and I’ve only ever made one claim under private insurance in my life and the total bill was only £1400. Private medical offered to normal employees doesn’t really plug the gap in the NHS services
- technologia 4y ago~$350/month, which to me has been useless so far. Generally costs about 20k USD a year in the US split between employers and employees
- throwaway774674 4y ago€120/month (€1440/year) with a €385 per year deductible. Or €100/month (€1200/year) with a €885 per year deductible (the legal maximum in the Netherlands).
- VLM 4y agoAround $1500 for a family of four.
- BrianOnHN 4y agoIt's $0 to not buy-in to a broken system.
- ceejayoz 4y agoUntil you get sick.
- ceejayoz 4y ago$2,400 a month, in NY, for a family of four. Going up 10% next year, too. Platinum plan on the exchange; costlier up-front, but comes with a $4k/year cap in copays we hit fairly early on, so it makes sense given our particular set of expenses. Cleared $40k in total medical expenses last year. Moving back to Australia looks better every year.
- deleted 4y ago[deleted]
- fspeech 4y agoRight now (till 2025 if Congress doesn't extend it) the premium is limited to 8.5% of income if you buy your insurance through the public ACA exchanges. You do have to reconcile the actual amount through the premium tax credit at tax season. The premium limit is for a silver plan so there will be out of pocket expenses if you actually need care.
- alphabettsy 4y agoPretty sure the credits have an income cap that would put most or all engineers out of eligibility, but the premium limit is still there. Decent calculator: https://www.kff.org/interactive/subsidy-calculator/ https://www.kff.org/interactive/subsidy-calculator/
- fspeech 4y agoCongress removed the cap during the pandemic and extended to 2025 recently in the inflation reduction bill https://www.kff.org/policy-watch/five-things-to-know-about-renewal-of-extra-affordable-care-act-subsidies-in-inflation-reduction-act/ https://www.kff.org/policy-watch/five-things-to-know-about-r... . Of course if premium (of Second lowest cost Silver plan (SLCSP) https://www.healthcare.gov/glossary/second-lowest-cost-silver-plan-slcsp/ https://www.healthcare.gov/glossary/second-lowest-cost-silve... , not the actual plan you buy) is below 8.5% of your income then there's no subsidy, which seems fair to me. So the subsidy depends on the cost (mainly your age) and your income. In the calculator you linked you can see what I mean by putting in an income of 100000 for an older couple and getting significant subsidy. Note one has to buy through the exchanges to qualify.
- devonkim 4y agoVia healthcare.gov and COBRA from living in a state that dragged its feet maliciously and a prior employer in a really poor state with an awful risk pool for a family of two adults that cost me $1500 / month for mediocre coverage in 2015. It was so high it blew through my runway far faster than I had budgeted and along with other unforeseen factors led to me stopping with my independent contracting work basically ever. It was high enough I paid out of pocket for everything and had a catastrophic plan only for still $500 / month.
- daniel_reetz 4y agoIndividual about ~600 month for high deductible coverage.
- Macha 4y agoIt costs my employer €180/month, which translates to €90/mo in additional tax from me due to it being a taxable benefit in kind. I could sign up for the same plan individually for €120/mo were it not handled through my employer.
- roebk 4y agoJust shy of 500 GBP a year for myself via Bupa. That includes a fairly compressive policy excluding dental. Family are all fallback to the NHS (sorry family).
- swayvil 4y agoAre we paying rent on our body now? Is that an accurate way to describe it? Ideally (from the farmer's POV) you will utilize every part of the cow. Lips to lungs. Which is to say, rent will be collected on every single facet of existence. It's like being wrapped in a rent-absorbing membrane. A rent-stomach.
- choko 4y agoNo, you are paying for your own biological needs. It's no different than having to spend money to buy food. It's not at all accurate to equate these costs to rent.
- swayvil 4y agoYou trust this business much more than I do. It strains credulity. This business charges exactly what the market will bear. Not what servicing the "biological need" actually costs them. But that's obvious.
- xboxnolifes 4y agoSame goes for everything else
- swayvil 4y agoExcept health is something literally everybody wants so much that they can charge literally anything. That's a big difference. It's like charging for air.
- choko 4y agoNo, it's not. Air is not something that I'm dependant on someone else to provide. Healthcare is dependent on the labor of others, something to which you are not entitled to by default.
- tomas_nort 4y ago
- johncoltrane 4y agoThe gap between the US prices as reported here and the rest is mind boggling.
- jmclnx 4y agoWhat Country or US State ? The answer depends upon that plus income level. With ACA in the US best to check the WEB site of the state you live in.
- trhoad 4y ago£500 per year, Bupa, "comprehensive" cover (basically everything paid for)
- beej71 4y agoGo to a broker online and get quotes for you. It's highly age-dependent. Also go to healthcare.gov and see what your subsidy options are. I normally pay $550/mo for high deductible for me individually, but actually pay $42/mo right now because I wasn't making much money this year. ACA FTW. I just got a job that comes with great insurance, though, so that's the end of all that.
- voisin 4y agoAs someone from outside the US, I have two questions: 1) are these amounts tax deductible? 2) given the size of these amounts, OP’s statement that these are a big barrier to going independent would seem totally reasonable. Doesn’t this have a chilling effect on new business formation? If so, how is the US still so well known for startups? It seems significantly riskier than in other countries with better safety nets.
- lowercased 4y agoFor someone self-employed, the numbers are tax-deductible. If you're employed, but still have insurance and expenses that aren't covered, those expenses need to be more than ... 7% of your adjusted income to be deductible (but only the amount over 7%). The 7% might not still be the correct number, but it's something like that. So... you have a job, but there's no employer-provided health insurance. You make $60k/year. Your adjusted income (after some deductions) might be, say, $45k. You decide to buy your own health insurance, and it costs you $500/month. That's $6k/year. 7% of $45k is $3150. So... $6000-$3150 = $2850 which would be the amount that you could avoid paying taxes on. Confusing much? > If so, how is the US still so well known for startups? Because there's metric-ass-loads* of money here looking for places to be invested, and we idolize the unicorn homeruns so much so that we have entire industries catering to their ecosystem. * Note, this is one of the few times we use the metric system in the US. 2 liters of coke/pepsi, and metric-ass-loads of <fill-in-the-blank>.
- Macha 4y agoInterestingly enough, the inverse of your comment is true here. "Gallons upon gallons" as a superlative, and drinks in pubs are the two uses of imperial liquid measures here
- lowercased 4y agoI watch a moderate amount of UK tv, and I'm still (decades later) surprised when one UK person says to another UK person "you look a million dollars!". "You look a million pounds" doesn't sound the same. "You look a million quid!" might be better?
- dom9301k 4y ago- 360 CHF / Month - Switzerland - 2500CHF / Year deductible - 1 person - ~30yo, good shape, no smoking, a beer now and than, office job this is just the health insurance, here in Swiss we a shitload if insurances.
- decibe1 4y agoAbout 1k a month. 2 non-smoking adults, 1 teenager
- diebeforei485 4y agoIt's not hard to find out - check healthcare.gov and also check your university has some sort of alumni plans - probably on eEhealth. Expect to pay ~$300/mo for a catastrophic plan that covers essentially nothing until you meet an $8K deductible, and ~500/mo for plans that cover more. Terrible system.
- prirun 4y agoI have ACA coverage now, and had it in 2020 when I made a trip to Mayo Clinic. Mayo was out of network, insurance wouldn't pay anything, so I investigated getting private insurance, figuring I could force a "life event" if necessary to switch insurance coverage outside the open enrollment period. I ran into lots of roadblocks: Part of ACA is that insurance companies can no longer refuse coverage or charge more for pre-existing conditions. IMO the insurance companies agreed to this because everyone was going to be forced into either buying insurance or paying a penalty to be self-insured (not carry insurance). The penalty was later removed by Congress, but the insurance companies were stuck with the no pre-existing conditions rules. https://www.hhs.gov/answers/health-insurance-reform/can-i-get-coverage-if-i-have-a-pre-existing-condition/index.html https://www.hhs.gov/answers/health-insurance-reform/can-i-ge... When I tried to get private insurance from major carriers, I ran into: - circular phone trees that couldn't be escaped - forwarding to "agents for my area" that never answered the phone - forwarding to agents that did answer the phone but said there would be coverage limits for 6 months since I had a pre-existing condition. This is illegal. One agent did give me a quote for $2400/mo with a $10K deductible. - I did find prices on the Internet that said private PPO coverage would cost about $800/mo with a $10K deductible, but no insurance company would actually write it. IMO, only writing new individual coverage (not via company employment) during open enrollment is a way for the insurance companies to keep their limit on pre-existing conditions. I ended up paying cash ($12K) for a 1-week visit to Mayo. In hindsight, paying cash was a better deal than if I had private PPO coverage: PPO would have cost $9600 in premiums (or more!) plus I would have paid the first $10K, so nearly $20K. Insurance in the US is a mess! I do have to add though, ACA has been a lifesaver for me.
- catoc 4y ago$400* for a family of 4 with teenage kids (converted from Euro, in NL) That covers everything from biannual dental checkups, physiotherapy and any & all GP visits to chronic medication, oncologic immunotherapeutics or months long stays in an intensive care unit, etc. Not gloating/bragging, our family didn't create the system. Just lucky to be born here. * including all own risk/"excess"
- byecancer21 4y agoMy rate for private health insurance in Germany is nearly 9.6k EUR/yr, not including family. This is a contract so terms can vary. Here: zero deductible, vision and dental included, international coverage including US. Includes a savings-like provision required by law. It is designed to keep rates affordable over time.