After two years and exactly $ 37 worth of claims against full medical and dental insurance, I quit my job to work on my own.
The first week alone, I was terrified. My security blanket had vanished. I wasn't overly worried -- having successfully free-lanced before -- about the loss of a steady paycheck.
But I was sans health insurance in a world where Blue Cross means never having to say you're sorry. Would I be turned down in the emergency room because some sharp-eyed receptionist noticed my group insurance card had expired? More than 183 million Americans have some form of health insurance, the vast majority through group coverage. I didn't belong to a group any more. I envisioned myself ending up in a ward somewhere for the terminally uninsured.
Ultimately, this paper crisis had a happy ending: I am covered to the tune of a million dollars ($ 500 deductible), and I pay only a little over $ 13 a month for comprehensive health insurance. Some of the monthly rates I had been quoted rival mortgage payments. A few extra calls easily saved hundreds of dollars, but my insurance bargain didn't surface until after I posed the same question to two agents for the same company.
Ironically, I never had much real use for health insurance, as my minuscule claims record indicates. But tell that to a steely nurse who wants to know about method of payment. Hospital beds rent for upwards of $ 200 a day. So while I should have been haggling with editors, I negotiated with insurance agents.
Artists, consultants, lawyers and others who are self-employed must also provide for their own insurance needs. Part-time workers may not have insurance benefits. And the federal government is adding thousands of RIFfed (Reduction-in-Force) workers to the unemployment rolls and health insurance limbo.
The cost for thorough coverage for just one person can easily exceed $ 1,000 a year. It's a virtual necessity that is often a shock to an independent budget.
"The cost of outside insurance was overwhelming," says Lisa Krieger, 26, a former free-lance writer now working fulltime as a medical journalist.
"People who are self-employed are in bad straits. You're so used to someone else taking care of it." For Krieger, the absence of health insurance "was a very strong motivation" to seek a salaried position.
Health insurance "is a serious issue for free-lance people or parttimers, especially for singles who cannot get it from their spouse's job," declares Diane Rothberg, president of the Association of Part-Time Professionals.
Yet, I smugly assumed the insurance agents would vie to snag such a desirable prospect: I'm 25 years old, I play softball five nights a week and I don't smoke.
After my bout of telephoning, I emerged like Sugar Ray Leonard, victorious but bruised from the struggle. Useful information often has to be extracted forcefully by persistent questioning.
It took more than two weeks for the company handling my group insurance to finally return my calls about extending my policy. Even the nice young man who eventually wrote my policy candidly admitted the low-premium sale wasn't worth the trip to my house. He hoped to hook me for life -- as well as homeowner's insurance. Another agent, very professional and helpful, casually eased the conversation into a discussion on the merits of individual retirement plans also handled by his agency.
The reason for the unenthusiastic treatment is rooted firmly in the economics of scale. "The insurer would rather deal with one person for the coordination of 2,000 people, than collect 2,000 premiums," observes Neil Swan of the Health Insurance Association of America.
"With that in mind, you should never turn down group insurance," warns Swan. Individual insurance is "significantly more costly a year," he says, because of "the administrative problem."
Professional or fraternal groups sometimes offer health insurance plans. Washington Independent Writers, for example, gives its members a choice of two health plans. WIW member Krieger opted to pay $ 48 a month to join a health maintenance plan affiliated with George Washington University Medical Center, which provides routine, emergency and hospital care through the university's medical facilities.
However, WIW's version of the popular Blue Cross/Blue Shield protection comes at a cost that might adversely affect blood pressure. Even with the group discount, an individual must fork out $ 1,409 a year for complete health coverage. The family rate is a staggering $ 3,554 annually.
The idea of writing a monthly check that would be six times my yearly claims, drove me to the Yellow Pages. Insurance agencies account for 28 pages of the Washington telephone book, guaranteeing a wide cross-section of responses. As a Health Insurance Association pamphlet says, "Individual insurance requires careful shopping because coverage and costs vary from company to company.So, find out what the insurance will pay for and what it won't."
I wanted at least $ 1 million of coverage (which most insured Americans have) and didn't want to pay more than $ 1,000 out of my own pocket under any conceivable circumstances.
"The standard in the industry is becoming more and more a major medical deductible," said the first agent. In this case, the deductible was $ 100, with the first $ 5,000 in costs split 80-20, "The maximum exposure you would have would be $ 1,000." I had actually called Occidental Insurance, but agent Gunard Hill also handled Prudential. I could buy a piece of the Rock for $ 42 a month.
Next, I called a New York Life agent and again got a Prudential sales pitch. Gary Newman also informed me that I wasn't eligible for standard Prudential insurance because I didn't meet the requirement of being self-employed for at least six months. Despite my age and health, "You're caught," he said, "in the backlash of this rule."
But Newman also offered me a temporary policy significantly cheaper than a permanent one. For $ 31 a month, I could get a 180-day policy with all the benefits of a permanent one. It sounded like an insurance Catch-22, until Newman explained the seeming contradiction. "The company knows it's going to be off the hook in six months" if I turn out to be a bad risk.
Blue Cross coverage costs the same for anyone between 19 and 65, I was told. Limited Blue Cross/Blue Shield individual coverage costs $ 41 to $ 62 a month, depending on the benefits selected.
While my age didn't matter to Blue Cross, the Mutual Insurance agent saw it as quite an advantage. "Since you're a young man," said Dan Villamar, "we can give you an excellent rate." Mutual offered a $ 1 million policy for $ 36 a month.
To round out the telephone survey, I contacted the Group Health Association, a Washington area health maintenance organization that accepts individual applications. The prepaid medical treatment plan offers two monthly rates: basic (a nominal fee charged for many services) and the no-charge high option. Prices are the same for everyone; $ 46 for basic coverage and $ 63 monthly for high option.
In the end, I chose a temporary policy from the Washington National Insurance Company. Combining a relatively high deductible ($ 500) with million dollar coverage, I wrote out a check for $ 40 -- for three months of coverage. After grappling with insurance companies for several weeks, I eased my fears for a mere $ 13.33 a month.
I sought protection against catastrophic illness, not routine ailments, so the inexpensive high deductible was appropriate. A high deductible, according to insurance expert Swan, "is a good thing if your health risk is low. As your risk increases with age, you might want to re-evaluate."
If you have your health, you have everything -- so long as it's insured.
But you've got to shop around. As the Health Insurance Association says, "You can't afford not to."
A free pamphlet, "What You Should Know About Health Insurance," is available by writing the Health Insurance Association of America, Public Relations Division, 1850 K St. NW., Washington, D.C. 20006.