3 ms·

+1 this research being done. When I bootstrapped Parse.ly by doing consulting in 2009/2010, my biggest costs were rent and healthcare. I wrote about this in my

+1 this research being done. When I bootstrapped Parse.ly by doing consulting in 2009/2010, my biggest costs were rent and healthcare. I wrote about this in my blog post, "Startups: not for the faint of heart". http://www.pixelmonkey.org/2011/04/02/not-for-the-faint-of-heart http://www.pixelmonkey.org/2011/04/02/not-for-the-faint-of-h... To get a good "sole proprietorship" plan for me cost >$1,100 a month. My healthcare cost nearly as much as my rent in Astoria, NYC. I've spoken to many budding entrepreneurs in NYC, and they have told tell that the loss of an employer-provided healthcare plan is a major factor that stops people from quitting their jobs to start a company.

mgkimsal 13y ago
was this just for yourself, or a family? $1100 seems steep - a 'high deductible' HSA plan for a single person should be < $500/month - it's currently < $350 for two of us.
- riggins 13y ago
  was this just for yourself Might be NYC. I can tell you individual plans in NY run $1,500/month.
  - rdl 13y ago
    Why is NY/NYC health insurance 5-10x what it is in WA/CA?
    - bbanyc 13y ago
      New York state law requires strict community rating, which means that an insurance company must charge the same prices to all customers. Elsewhere people with known health problems are charged higher premiums to cover their higher health costs. In New York that's illegal, so instead everyone is charged high premiums.
      - rdl 13y ago
        Do people move/select based on this? I don't know if $1k/mo difference is enough to get people to move, since NYC is expensive (and thus obviously attractive to account for that). It would be an interesting study -- moving cities or states is way easier than countries.
- mjn 13y ago
  When I was looking (a few years ago, in California) I had trouble finding HSA plans that included prescription-drug coverage (even with a very high deductible) for less than ~$400-500/mo. There were plans cheaper than that with no drug coverage (starting around $200), but that leaves you on the hook for unlimited liability if you end up needing an expensive prescription (and some can be very expensive). I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end.
  - mgkimsal 13y ago
    It seems it's a bit of a shell game... $500/month with some prescription coverage is a guaranteed $6k/year. $200/month without prescription coverage is a guaranteed $2400/year - $3600 savings. If you know you'll have more than $3600/year in prescription costs, then this plan doesn't necessarily make sense, but unless you know you'll have that much in costs, it doesn't matter. I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end. Not sure what you mean. Those are the only HD/HSA plans I see - you self insure up the first $2k/$5k/$10k, and the insurance plan covers stuff after that. Most I've seen, deductibles under $10k carry a co-insurance split between you and the insurer up to a certain amount. In our case, if we just took the $10k deductible, we'd get everything covered after our initial $10k, and that is the 'lowest' end (I'm thinking you're meaning cost - maybe you mean something else?)
    - mjn 13y ago
      My worry is coverage of prescription drugs above $10k/yr. I'm perfectly fine paying for normal prescription drugs, but when I was looking for high-deductible insurance, all the cheaper plans explicitly said "no prescription drug coverage", even above the high deductible, which I didn't feel comfortable with. To me the idea of the high-deductible plans was that I cover regular costs in return for coverage in the event of a catastrophic illness. For example, in the unlikely event I'm diagnosed with MS and need a Copaxone prescription ($40k/yr), I can't self-insure that amount.
- deleted 13y ago
  [deleted]

mgkimsal 13y ago

was this just for yourself, or a family? $1100 seems steep - a 'high deductible' HSA plan for a single person should be < $500/month - it's currently < $350 for two of us.

riggins 13y ago
was this just for yourself Might be NYC. I can tell you individual plans in NY run $1,500/month.
- rdl 13y ago
  Why is NY/NYC health insurance 5-10x what it is in WA/CA?
  - bbanyc 13y ago
    New York state law requires strict community rating, which means that an insurance company must charge the same prices to all customers. Elsewhere people with known health problems are charged higher premiums to cover their higher health costs. In New York that's illegal, so instead everyone is charged high premiums.
    - rdl 13y ago
      Do people move/select based on this? I don't know if $1k/mo difference is enough to get people to move, since NYC is expensive (and thus obviously attractive to account for that). It would be an interesting study -- moving cities or states is way easier than countries.
mjn 13y ago
When I was looking (a few years ago, in California) I had trouble finding HSA plans that included prescription-drug coverage (even with a very high deductible) for less than ~$400-500/mo. There were plans cheaper than that with no drug coverage (starting around $200), but that leaves you on the hook for unlimited liability if you end up needing an expensive prescription (and some can be very expensive). I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end.
- mgkimsal 13y ago
  It seems it's a bit of a shell game... $500/month with some prescription coverage is a guaranteed $6k/year. $200/month without prescription coverage is a guaranteed $2400/year - $3600 savings. If you know you'll have more than $3600/year in prescription costs, then this plan doesn't necessarily make sense, but unless you know you'll have that much in costs, it doesn't matter. I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end. Not sure what you mean. Those are the only HD/HSA plans I see - you self insure up the first $2k/$5k/$10k, and the insurance plan covers stuff after that. Most I've seen, deductibles under $10k carry a co-insurance split between you and the insurer up to a certain amount. In our case, if we just took the $10k deductible, we'd get everything covered after our initial $10k, and that is the 'lowest' end (I'm thinking you're meaning cost - maybe you mean something else?)
  - mjn 13y ago
    My worry is coverage of prescription drugs above $10k/yr. I'm perfectly fine paying for normal prescription drugs, but when I was looking for high-deductible insurance, all the cheaper plans explicitly said "no prescription drug coverage", even above the high deductible, which I didn't feel comfortable with. To me the idea of the high-deductible plans was that I cover regular costs in return for coverage in the event of a catastrophic illness. For example, in the unlikely event I'm diagnosed with MS and need a Copaxone prescription ($40k/yr), I can't self-insure that amount.
deleted 13y ago
[deleted]