Researching Health Insurance Plans for My Daughter

Updated on September 11, 2009
D.C. asks from Saint Louis, MO
24 answers

Hello Mamas,
Just wanted to get some feedback from you about private health insurance plans. My husband lost his job so we need to get coverage for our almost 2 year old daughter. My employer wants $315 a month which seems very high so I am checking into some other plans. If anyone could share their experience that would be great. Any feedback is appreciated.

Added update-My son has insurance through his biological father. My husband's new job will provide coverage after 90 days for him but it is not a very good plan and is as expensive as my employer to cover my daughter. My employer pays for my insurance so I am just looking for her only. Thanks for all the feedback so far.

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So What Happened?

Thank you MAMAS for all the great feedback! We found out that our neighbor is a broker and we got a plan today through BCBS of MO for only $73 a month covers all well child visits 100% and $25 copay for sick visits. After that we have a $2500 deductible but it is still less expensive than what my employer charges for GHP.

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A.H.

answers from Topeka on

I have Coventry for my son. He's 4 years old and I pay $56/month for him. It's a high deductible, but I have a copay for dr. visits and such and I like that. He's been with them for a few years now and I've never had any problems with them. I would highly suggest them.

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D.M.

answers from Kansas City on

Me and my son (19mos old) have had Humana since he was born/I left my job (18 mos ago). Its been just fine, granted I never go to Doctor, bu all of his have been covered overall (regular well-visits, etc). No problems, good customer service so far! His is around $87 I think and mine is like $126 or so a month. Not too bad at all!

Only thing to think about.........and you may be done having children, is they do not offer maternity coverage.....

S.B.

answers from Topeka on

Have you tried getting Medicaid? It covers everything from dental, eye exams and glasses, regular doctor visits, specialist, prescription meds.... Did I mention it is FREE!!

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K.S.

answers from Kansas City on

We had a family plan through Humana and it was $315.00 a month(Not bad!)We were covered if anything major happened, but our son was pretty much covered for everything. Health care is not that unreasonable, contrary to what everyone thinks, you just have to do your research and I think you'll be surprised. Our same plan, had we done it through our small business would have cost us over $1000,00 a month. I think people take for granted just how much extra business's do pay for their employers. Good luck!

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L.K.

answers from Kansas City on

Is the $315 a month family coverage? Even if is is just for your daughter, quite honestly that isn't that bad. Healthcare costs, especially for employers who offer insurance has risen a lot over the years. You need to find out what you get for that. What does it cover? Well child visits or just sick care? How much does it cover when you go in? Can you pick your own docs? Does it cover prescriptions? What does it cover?

I mean no offense by this so please do not take it wrong. First of all I am NOT an employer so I am not speaking on the behalf of employers. But I am a nurse who has worked in a variety of areas of healthcare. But my point is that for so many years people (my husband and I included) just took their employee provided insurance for granted. Even if you had to pay a portion of the premiums, many times employers had the biggest share. Now unfortunately with people loosing their jobs and researching this on their own they can't believe how expensive it is.
My husband and I recently, by our choice, went to a high deductible insurance. Basically we pay everything out of pocket up to the first $5000. I realize not everyone can do that. But it 1). makes us think twice about any health related decisions we make. And 2) opened our eyes to the way docs charge just to get their money from insurance companies. I recently had my physical and had my doctors office set it up as a "private pay" or someone who does not have insurance since we pay for it anyway. Just one of the blood tests I had was $25 as a private pay. If they would have billed for the insurance that one test would have been $200!

I would be interested in a follow up if you find something decent cheaper.

In good health,

Lori K

1 mom found this helpful
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N.F.

answers from St. Louis on

Hi D.,

Just a thought - was your hubby not offered COBRA! With the new law that was just passed when offered COBRA and your job was lost because of lack of work, the employer that did the letting go has to pay 65% of the premium for 9 months, but you can carry COBRA for another 9 months at the full premium price. You can't just carry the dependent, but surely the COBRA at 35% is cheaper then what you are finding?

N.

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H.M.

answers from Springfield on

Research, research, RESEARCH!!! Look at the fine print- what's covered, what isn't. Consider which hospital you pre-fer, and then you will have to find ones that are "contracted" with them. IE- Cox- BCBS, United HealthCare, GreatWest. St John's- Aetna, Healthlink, PHCS-(Private Health Care Systems), Cigna, MO Medicaid, etc. If you have questions about specific ones... search their websites, there's one they've been talking about on the radio that compares coverage. Do NOT get Celtic insurance!! They don't cover anything except major medical- not, a good choice with a small child. If you have specific questions- email me. I verify insurance all day long @ the best Hospital in Springfield & SouthWest MO.

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K.J.

answers from Kansas City on

I'm not sure what MO or KS does for state health insurance, since we are fairly new to the area, but we have had to do that for our son when we lived in FL and I lost my job. You could always check into it, though. Otherwise, in my experience, United Health Care or BCBS have always been the most reasonable. Most of the time, you can get a quote online for the health insurance.

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K.O.

answers from Wichita on

Hi D.. You also mentioned a 13 year old son. Is he covered by another form of insurance? Insurance isn't cheap, but to do without coverage for all of you is a very risky proposition. It just takes one moment in time to have a catastrophic accident that can put you in debt for the rest of your lives.
Our son just two years ago fell and hit his head on the concrete at swimming lessons. He was not running or anything; the diving board was slippery and he literally just fell off. The first of several bills was $14,000! Thank goodness we had insurance! By the time all of the bills came through, we paid a mere $350! Get family coverage even if it is financially difficult; the alternative is too risky!
We pay over $1000 for the six of us. Make the sacrifice and cut corners on something else. You all need the coverage not just your daughter. Imagine if you had a car accident and both you and your husband were severely injured or died. Guess who has to pick up the cost (especially if you do not have disability or life insurance)? Yes, it falls to the immediate family, your daughter included!
Good luck! I feel for you in these difficult times. Take care of yourselves.
K.

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S.H.

answers from St. Louis on

$315 is not very high....we pay >$650/month for a family of 4. This rate is the same for a family of 3 or more.

We have a friend who just had knee & disc surgery. He has a family of 5...& his insurance will be covered thru disability, but his family's rate will be $900/month! Ouch!

Here's hoping for positive changes in our medical fields.

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W.H.

answers from Kansas City on

Hello!

To speed up shopping, go with a broker who represents MANY plans from MANY companies.

I am really pleased with Mark Squires of Squires First Financial. He talked everything through, and did not pressure me into anything.

Here is his website: http://www.myhealthplantoday.com/
His cell number is ###-###-####.

Tell him that his client, Traci Holman, says "hi".

Traci

wwww.cleanducts4kc.net

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J.C.

answers from Kansas City on

D. my husbands company just changed plans to one that would cost a very high jump in premiums for my 4 yr old daughters portion so we looked into individual coverage for her and we got a plan through blue cross blue shield of kansas for her thats a little more than 100.00 a month it has a couple of draw backs only 5 visits in the covered year with just a co pay then after that it it goes to deductable of 1000.00 once you meet it, it goes to 80/20 coinsurance and we did get dental coverage with it. The plan is called first choice-affordablue program. I wish you the best of luck in finding coverage for your children.

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R.Y.

answers from St. Louis on

A broker is your best bet, we go through one. He gets competitive rates from several companies to find the best one for your needs. My whole family has used him and we even researched other companies and went back to him. His name is Donald Rehagen at Competitve Plan Design ###-###-####. Tell him I referred you (R. Y.). Many blessings to you!

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C.W.

answers from Kansas City on

When we lost our employee insurance when I switched jobs and the new company did not offer, due to being small, we went through Blue Cross Blue Shield of KC. This was in 2006 and we only paid $565 for four of us, two adults and two children. It was not a top of the line plan, but it covered what we needed. They also used to have inexpensive children plans. You can go out onto the websites for most health insurance companies and read through what they have to offer and get a base idea of premiums, as this is what I did before selecting BCBS of KC.

Good luck!!

J.G.

answers from St. Louis on

Family insurance coverage averages 1,400 a month, individual averages 800 a month for employer provided coverage. How much your employer passes on to you is their decision. With employer provided you are in a cost pool with all your coworkers so it tends to be a little higher if you are younger than the average employee but considering your employer pays part you still should be saving over getting a private plan. You also must consider the tax advantages of employer provided. The amount you pay in should be pre-tax which means you have a exemption from your gross income of the amount you pay in. So if you have a marginal tax rate of say 25% you will get back $945 in tax savings. Revenue Ruling 2002-80, 2002-2 CB 925, I.R.B. 2002-49, 925 I don't practice tax but I am pretty sure that is the correct revenue ruling.

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B.S.

answers from St. Joseph on

We got our kids private plans through BCBS for $85/month. My husband's employer wants $1500/month for the three of us to be added (two kids and myself).....yeah right! I actually laughed when he brought the paperwork home...
If she has any pre-existing conditions, they probably won't cover her....I do not have insurance due to this...it's not fun...but thankfully my boys are covered. Just look around, and get some quotes... Good luck!

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K.B.

answers from Kansas City on

I'm in the same boat as you are right now.
I checked with my employer and it will cost me about 210.00 to cover my son, they cover my insurance premium.

At first I was shocked but after checking insurance prices I may go with it.

My son has ADHD which I would have to wait a year on most plans before they even cover anything related to that. So I would be out of pocket for his medication which is $160.00 a month. Those who will cover it since he has insurance now, the medication will still be on the highest copay $60.00 plus the insurance premium of at least $80.00. They don't cover much as far as other things.

I don't have a choice to get a cheaper plan since the cheaper plans will not cover mental health (the ADHD)or they only cover a very small percentage.

If you don't have to worry about preexisting conditions. The plans I've seen that are reasonable are Blue Cross and United Healthcare.

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K.T.

answers from Kansas City on

Get an individual BCBS MO or KS plan for your child, they are absolutely the most reasonable and are so prompt on payment and explanation of benefits. I have carried one outside of my coverage provided by work for years and have had nothing but a great experience with them.

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J.H.

answers from St. Louis on

I just researched this myself. If you want quick quotes go to ehealthinsurance.com. MO Blue Cross Blue Shield has health savings accounts with high deductibles that have a copay for preventive care. I think tests that are with a well kid visit are also included. If your daughter rarely gets sick it might be something to check out.

Unfortunately I live in Illinois and there is no such plan here through Blue Cross Blue Shield. Determining which insurance companies will actually pay if you have a true emergency is more problematic. Illinois keeps complaint statistic ratios for each company. Maybe Missouri does a similar things. I really like the plans United Health Care had available. We had United Health Care through my husband's ex employer. However, the subidiary that handles UHC's individual insurance has bad ratings. Be prepared - some insurance companies want you to fill out a ton of paperwork. My friend has BCBS of MO. She has no paperwork. BCBS of IL you have to report if you have ever been counseled about any health condition imaginable.

Someone mentioned COBRA. My understanding is that if you are offered insurance through your employer you no longer qualify for COBRA unless someone has a preexisting condition.

As was also mentioned a lot of states are expanding coverage for kids under state and federal programs. The allowabe income in some states is really pretty high.

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C.B.

answers from Kansas City on

My husband sells Humana Insurance and would be happy to do a quote for you. You can email me at [email protected]____.com, and I'll get you in touch with him.

C.

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K.M.

answers from St. Louis on

go to ehealthinsurance.com
You can find anything there, from very very cheap basic coverage up to very expensive coverage that takes care of everything and then some. And thru companies we've all heard of.

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H.H.

answers from Kansas City on

if that 315.00 is a family plan that is pretty cheap compared to what others pay. My dad is a truck driver and pays 700.00 a month for just him and my mom, it was that high when the kids were home too but that was the family plan cost as well.

Check out MC+ if you are in Missouri, it is for low income families and sometimes you have to pay something depending on your income but it is based on income. It will only cover your kids though. I don't know what the KS one is called but there is something similar.

Even the military retirees have to pay for insurance now which used to be provided free. It isn't a lot but then the coverage isn't that great either because it is hard to find a good doctor that takes it because the insurance doesn't pay much and usually doesn't even cover the doctors fee. We mainly use it for pharmacy and pay another plan with hubby's job so we pay 250.00 a month with 20-30.00 copays for insurance and that is with a company with good benefits so even with the best jobs there is insurance to pay.

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K.P.

answers from Wichita on

Finding individual insurance can be difficult, but you've gotten some good advice from others. If Congress were to enact laws making it legal for health insurance cos. to sell policies across state lines, it would increase competition and lower prices. And tort reform would eliminate frivolous and ridiculous lawsuits/judgments against doctors and hospitals, which would also lower costs. I hope your situation isn't bad enough that you qualify for Medicaid. While it may be free to the recipient, the rest of us pay dearly for it in our taxes.

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H.M.

answers from Topeka on

In Kansas, thye offer, Kansas Health wave, I've not used it but if you are looking just ot cover your child that would be something to check into.

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