Health Insurance

Getting healthcare coverage is essential, but finding the coverage that best suits your needs can be confusing and complicated. I don't begin to pretend to have all the answers but hopefully the information I have collected will help teachers make more educated decisions regarding health insurance.

 

The key for us teacher is to be educated about fair market prices for services and to understand what our needs are versus what the coverage actually provides. 

The type of coverage you will need will greatly depend on how you plan to use the insurance. For example a person who is planning to have a baby has certain predicted cost and may choose coverage based on that, while another person may only want to minimize cost if an unforeseeable event shall incur major medical cost. 

 

Many Thanks to teacher Jennii Fielding who gave me permission to use some of her information in the making of this page. 

Three topics I want to focus on are:

1. Online Teachers Insurance Group

2. Coverage Options

3. Negotiating Healthcare Cost

4. How to reduce out of pocket expenses

5. Youtube Videos

 

I will do my best to provide accurate and useful information but your best resource may be a Facebook group that seeks to find health care options for teachers.

 

One of the teachers from that group is an insurance broker and has contributed greatly to this page. I want to first acknowledge Teacher Jennii Fielding  and all the great work she has done to help teachers with health care. You can Join the Facebook group and DM her with any questions.  She also has Facebook page though I believe it is intended for a broader audience, the information is still great and you can ask questions the page My Health Care Expert.

This group has also obtained some insurance for teachers through a group. It does not cover all states at this time though they are working on it. I will additionally discuss their option in the next section.

The ReDirect Health is more like normal insurance, but it only covers the day to day things - it works great as supplemental insurance. The catastrophic portion of this works similar to a Christian Healthshare, but it's nondenominational

 

Use this site to help find affordable insurance in your area https://www.healthsherpa.com

Re-Direct Insurance Group

This plan is one that has been found by some teachers who are also insurance brokers. You can currently learn much more about this plan and talk to teachers who use it at the Online Teachers Insurance Group

Here are a few points about this plan.

 

  • There’s no in or out of network providers so you can see any doctor you want.

  • There’s no deductibles on the Everyday Care plans, so you can start using the benefits right away.

  • The deadline for coverage is February 20th and your coverage will start on March 1st. You can enroll at anytime after this, and the deadline will always be the 20th of the month with coverage starting the 1st of the month after.

Not All States Are Included: 

 

ME, MN, MT, NH, NY, SC, VT, and WA and not included.

Is this the right plan for me?

a) If you qualify for a significant discount on the ACA marketplace, this coverage may still be more expensive. If your marketplace coverage has a really high deductible, the Everyday Care can be a great add-on to help cover your expenses before you reach your deductible.


b) If you have a lot of pre existing conditions, this plan might not be right for you. Sedera Health will only cover pre-existing conditions after the first year, and then you will get partial coverage that increases each year until year 4. After year 4, all pre existing conditions will be covered like any other sickness.


c) If you are currently pregnant, this plan will not cover your pregnancy. Pregnancy is covered if your due date is 12 months after your coverage start date.

More Information

There are essentially two parts to the plan - an EverydayCare plan through Redirect Health that will cover your office visits, labs, immunizations, and prescriptions without having to meet a deductible. You’ll also have an optional add-on for catastrophic coverage through Sedera Health. Basically, you pay for the coverage you use, and nothing else!

I’ve attached a pdf of the plan option details and prices. The easiest way to understand this coverage is by visiting our link and watching the videos. When you hit “Get Started” you can enroll, or speak to a ReDirect Health agent if you have any questions.

https://get.redirecthealth.com/onlineteachers

Your Spouse or Domestic Partner's Plan

If your spouse works and has coverage through their employer, this may be a good option. Because it's an employer-based plan, it may also save you money, because it may charge a lower premium for dependents.

Even if you are not legally married, you may qualify as a domestic partner if you share the same home and live a domestic life together — as long as you are not married to anyone else.

Affordable Care Act (ACA)

Depending on your income and household size, you may qualify for Medicaid,the Children’s Health Insurance Program (CHIP)premium tax credits or other savings options through the Affordable Care Act.

Create an account and complete an application to find out what benefits you’re eligible to receive.

Pros

  • Affordable if you qualify for subsidy

  • Pre-exisitng conditions can't be denied.

Cons

  • High premiums for middle class

  • High Deductables

Health Insurance Companies

Health insurance companies like Cigna and UnitedHealthcare offer private health insurance plans for self-employed people.

The companies offer a wide range of price points and coverage options to choose from. It can be difficult to figure out the right one to choose, but it’s worth it to spend time researching your choices.

COBRA

If you had access to a health plan from a previous employer, parent, or spouse, you can continue that coverage for up to an additional 36 months depending on the circumstances. 

The Freelancers Union 

 

is a non-profit organization that advocates for self-employed workers. They hold regular meetings every month in which they discuss ever-changing labor laws and distribute relevant information to attendees.

They also help to connect independent contractors with valuable resources like healthcare plans.

https://www.freelancersunion.org/health/

Health Care Sharing Ministries

Healthcare ministries are not insurance. Boiled down, medical cost sharing, or health sharing ministries, are a group of like-minded individuals that agree to come together and help each other pay their medical expenses. They offer faith-based programs for planning for unforeseen medical expenses. They're not for everyone, but they are definitely worth exploring.

Pros

  • Cheap way to avoid penalty from ACA.

  • Often less out of pocket expense

  • Services and procedures often cost less

  • Good if you're never sick.

Cons

  • Not actually insurance

  • Member pays for services and is later reimbursed 

  • No Pre-exisiting conditions

  • Rx can be difficult

 

Negotiating Prices

  • The Price for the Same Procedure varies. The prices can be very different for the same exact procedure with very little difference in quality. They do this because we as consumers know very little about the real cost.

1.

  • Know the Fair Price for medical procedures.

  • Use the healthcarebluebook.com to find the real cost in your area.

2.

  • Call billing office and negotiate a price based on fair price.

  • Be tough.

  • Escalate if needed.

  • Ask "how much does Blue Cross/Blue Shield pay?" 

3.

  • Pay Promptly

4.

  • Ask for Cash Price

5.

  • If you still have not been successful you might call a healthcare negotiation company. 

  • They should not charge until bill is successfully negotiated.

6.

How to Minimize Out of Pocket Expenses

 
 
YouTube

After doing a bit of research I found a really good channel. This channel is run by a woman named Dr Taffy and she is highly informative. I would say do some research before trusting anyone online, verify their information and use common sense. This is here channel, I thought it might be helpful. 

Own Your Health Care

The information on this website is for general information purposes only and is not intended to diagnose, treat, prevent, or cure any disease.

The sole purpose of this site is to serve as a resource of online ESL teachers. To educate and promote safe occupational health measures that to enhance the teaching experience.