Sunday, December 10, 2017

Background on Our Situation

My wife (age 36) and I (age 38) have three boys (ages 8, 6 and 3) and live in the Cleveland, OH area. We receive the majority of our medical care from the Cleveland Clinic. The Cleveland Clinic is an excellent hospital systems ranked nationally in multiple specialties. We also utilize the University Hospitals system in Cleveland for certain caregivers. We are both self-employed and do not qualify for subsidies under Obamacare. Prior to signing up with Liberty we were insured through Medical Mutual of Ohio, a Cleveland based insurer. Our plan included a $6,400 individual deductible and $12,800 deductible for the family. The plan was eligible for a HSA which we contributed to. We paid $926 per month for this coverage. We live a relatively simple life and this cost, alone, was substantially more than our monthly mortgage and property taxes combined. That said, we had insurance and were fortunate enough to afford it so we reluctantly paid the premium.

Along Came 2018
We anticipated an increase in premium in 2018 so we were not surprised when we started looking at plans. We were, however, surprised that our current insurer no longer offered coverage for our existing caregivers. Thus, if we wanted to maintain our doctors we were forced to pay a much higher premium through a new insurer partnering with the Clinic: Oscar Health. The price to keep our current plan was over $1,200/month but, as mentioned, it did not offer in-network access to our existing caregivers. A plan from Oscar was slightly more than our existing plan at close to $1,300/month but it did offer access to our primary caregivers. The cheapest option we had through brokers and the exchange was close to what we were currently paying but these plans did not offer access to our doctors and offered a very limited number of providers. And, at the end of the day, we felt we were paying too much as is.

About our Health
We have been lucky to have good health and want to be clear we are in the fortunate position to have no significant pre-existing conditions. It’s important to acknowledge that this has put us in a position to require a very moderate level of healthcare service and no significant procedures. We are sensitive to the fact that good health is a blessing and even those with healthy habits could find themselves in a position with a significant health issue. While we are not perfect we do put an emphasis on good nutrition and workout regularly. We believe in the power of nutrition, proper sleep and exercise. That said, we understand even with those habits a significant illness could occur and we evaluated our options with that perspective in mind.

The Options we Evaluated
This section provides a clear overview of the options we considered prior to opting to sign-up with Liberty Healthshare. At no point did we realistically consider not purchasing any coverage so we have not listed that as an option. We also never considered working for a company that offers health insurance as we enjoy our current self-employed endeavors.

Continue with Current Plan from Medical Mutual of Ohio – This option would cost $1,128. The deductibles are $6,400 for a family and $12,800 for a family. It includes a HSA but is not accepted at the provider where the majority of our healthcare is performed. We could find other doctors (I am sure there are many great ones at other providers) but we have a track record with our current providers and would prefer to stay if possible.  

Select a New Plan from Oscar Health – Oscar is a new insurer that promises more innovative technology and a more modern approach to insurance and healthcare. They have partnered with the Cleveland Clinic, our primary provider, so this was the most realistic option if we wanted to stay with our current providers. The option we considered cost $1,289 a month for a $6,500 individual deductible and $13,000 family deductible. The plan included basic child dental care and access to an HSA. While the cost was about $150 more than our option with Medical Mutual the big draw was access to our current health providers.

Select a New Plan from Caresource – A third traditional insurance option we considered was a plan from Caresource. This plan cost $911 a month for a $7,250 individual deductible and $14,500 family deductible and included basic pediatric dental coverage. While the price of this option was the most affordable of the traditional insurers it offered us the least access to providers. The network was more limited and did not offer access to our current health provider. The Medical Mutual plan we considered at least had access to a wide variety of providers, if not our current provider.

Purchase Short Term Insurance Plan – I also did limited research on short-term insurance plans. These plans were offered for limited periods and were more catastrophic in nature. Beyond doing some basic diligence we did not consider these plans seriously.                                                                                                                      
Enroll with Liberty Healthshare – The final option we considered, and the reason you are here, was Liberty Healthshare. I won’t go into a great deal of detail here because the rest of this blog includes information on Liberty and how we evaluated our decision.

No comments:

Post a Comment