I’ll admit I balked at the suggestion by Anne Wayman that I investigate Demand Studio’s new healthcare plan offering. I’ve all but closed the door on worrying about DS and those who choose to work there. But the idea of a healthcare package intrigued me. So I went digging.
First, it’s not a typical insurance plan per se – it’s a fixed-dollar benefit payment plan that offers limited coverage for “covered” medical expenses. And make no mistake, DS is not contributing to this at all (they say so in their footnotes). It’s something you can buy on your own once you reach various quantity-based earnings thresholds (30 articles written a month, 200 edited, etc.).
It’s pricey. Because you’re not in a traditional employer-sponsored plan, your out-of-pocket costs are more than that $15 copay some of us are blessed with. The monthly premium cost, touted as “under $90” is actually $91.16. A minor point, but what are you getting for that premium?
You get discounted prices. You also get 4 doctor visits per year at a discounted rate – between $50-$75 per visit. You get one health screening – $100. You get up to 5 prescription per person per year – $5-15. No mention of what you do if you happen to need monthly prescriptions for an ongoing issue. You file your own claims with the company and you choose your doctor from a network (which I couldn’t access for some reason). It covers hospital stays up to a maximum of $500-$1,000 per day for 30 days. It pays anywhere from 50% to 100% for operations, though the paperwork refers to some Schedule of Operations pricing guide on which this percentage is based.
Is it a great plan? No. It’s a discount program and it helps, but it’s not perfect. I don’t think anyone would disagree with that.
Just for fun, I compared it to what we can get through eHealth Insurance. Typing in my own geographic and age info, I found plenty of options for traditional coverage (93 to be exact). The lowest premium was $103/month.
The best, a Blue Cross plan, costs $262 monthly with no annual deductible and a $20 copay for doctor visits. The prescription deductible – $250 for an individual, then you pay $15 for generic drugs.
The lowest priced, an Aetna plan, had an annual deductible of $7,500, then you paid a $30 copay per office visit. Not a great plan, but if you have chronic health issues, the deductible could easily be met. The most you’ll pay annually out of pocket is $10K. If that sounds like a lot to you, it is. I don’t have that lying around, either.
The bottom line – yes, DS does offer a discounted health services option. No, it’s not a traditional coverage plan. Yes, there are other options that would cover much more. No, they’re not going to cost $91 up front, but you have to consider how much out-of-pocket expense is required for all the plans. Don’t choose based solely on premium price.
Also, the options that exist beyond DS are numerous. It’s always going to be my opinion that working for less than you’re worth – health care discounts or not – is never a good idea. I worry that a person in that desperate a situation to take a discount program and lock themselves into working for less than they can get elsewhere sells himself or herself short. It is indeed a free country and folks are allowed to do what they like. I would suggest taking on better paying clients so you can pay a little extra each month for more peace of mind.
What do you do for health coverage?
It appears to be like any other discount healthcare program. But, what gets me is that they seem to be using this to save face and get more writers on board by hyping themselves up and saying that they're the only ones to be offering such a great healthcare plan to their freelancers.
Like I've said in a few other places; I would've been more impressed if they had raised rates and cut the workforce first and then came out with a healthcare program.
Sure, everyone who qualifies, can take it or leave it, but I'm not seeing why they made this out to be so great before they released the details. Unless, of course, they wanted to add to their contractor numbers to meet their million pieces a month quota, or whatever it is.
Hi Lori.
I have a catastrophic plan with Blue Cross Blue Shield. For a hefty $280-something a month, I pay the first $5,000 of my health expenses (thought I do get prescription coverage), and the insurer will pay everything after that.
I've yet to meet my $5,000 deductible, but I'm not getting any younger. So someday I'll have a health problem, and we'll see how good that coverage is.
I do feel comforted, however, knowing that I have coverage if something goes horribly wrong.
The thing that struck me when hearing about DS' "heath care coverage" was that it's another ploy to make "writers" more dependent on them. In order to qualify for the opportunity to pay for your plan, you probably have to crank out more copy per year than most professional writers would (and we'd get more than 100-times the pay for that work).
And where in the US can you find a hospital that's only $500-$1,000 a night??
Heath insurance is important to me, but after what happened to my sister, I will never trust an insurer to honor their own contracts.
Here's why: My self-employed sister had a policy with one of the major carriers Lori mentioned above, but as soon as she was diagnosed with breast cancer they red flagged her file, tried claiming her newly-diagnosed cancer was a pre-existing condition, they also tried claiming chemo was a "prescription" (and therefore not covered in her policy), then withheld all payments for the six months it took them to invent a reason for terminating her coverage. The never paid a penny.
Ten years and several surgeries later, thank God she's healthy, but she's still paying off her medical debt. Until her recent marriage to a guy with employer-paid health insurance, the only coverage she could get cost her over $800/month – just her, super-high deductible, no vision, no dental, no coverage for any cancer-related issues. The kicke? That state-mandated policy was run by the very company she *thought* she was covered by before she got sick!
I have a policy with a $2,500 deductible I have yet to meet. It's an 80/20 plan, and as I understand that (Lori will correct me if I'm wrong) after I've met that $2,500 the company is supposed to pay 80% of the costs until I've paid another $2,500 out-of-pocket. Prescriptions are covered, but I'm not on any. Discounts are offered, which helps the out-of-pocket costs, but those discounts are a lot smaller this year compared with last year. No dental, no vision. I have an HSA to go along with it, but it irks me that while I can use the HSA to cover dental and vision, I can only put $2,500 in per year – and most banks have a monthly service fee, too. So I probably lose more in service fees than I get in tax breaks for having the HSA. But I do like knowing that money is there if I need it. Not that I've been able to contribute much to it this year.
I conferred with a broker before choosing this plan. We looked and maybe 5 or 6 plans. I didn't go with the cheapest, since they seemed to have a lot of loopholes and things they wouldn't cover. The one I chose has more options for preventative care. It costs me about $180/month. I wish I could say it gave me peace of mind, but after what my sister endured, I am unable to totally trust any health insurance company.
Paula, I can't blame you for not trusting insurance companies. The fact is healthcare insurance is a for-profit business in this country, which means claims decisions are sometimes based on financial decisions made by insurers. For the most part, insurers do an excellent job helping us cover for huge medical expenses. But it's also true some go out of their way to deny coverage as a money-saving option. I subscribe to one email list that sends me just court-based insurance claims appeals – the lists are insanely long each week.
Gabriella, it's true. Catastrophic coverage is essential. It's a shame it's not more affordable.
Wendy, I would have preferred that, too. But this costs Demand nothing – literally. Their own disclaimer is that it's not a plan they have any financial part in. So getting more money from them instead was never an option.
It's not a great deal. It's an option. It can be hyped any way they feel like hyping it, but the bottom line is it's a healthcare discount program, not insurance.
I sponge off my husband. When he decided to quit without having another job lined up, we were without insurance for a few months–during which we just tried to think healthy thoughts and used retail clinics (those affordable little places inside pharmacies and grocery stores–not all states have them, but we have a plethora here in Ohio) for simple, routine health care.
You seriously found that the most expensive/best plan was $262/month? Because Aetna was the cheapest reputable policy I could find and I pay almost that amount as it is. AND I have a $1,500 annual out-of-pocket deductible with it. That's a big difference. Don't we live in the same state? Because if I were to try to get a Blue Cross policy on my own, I can tell you right now it would be upwards of $500, maybe more. All that's not to mention that I have no conditions that would make me high risk and I take absolutely no prescription drugs.
Lori, you said:
The fact is healthcare insurance is a for-profit business in this country, which means claims decisions are sometimes based on financial decisions made by insurers.
Sometimes? Try nearly always!
I am a type 1 diabetic and I can't get an individual plan from private insurers. Period. It's perfectly legal to turn me down, so they will — every time. The only way I can get health insurance is via a group plan. If my husband didn't get health insurance from his job, I couldn't freelance — end of story.
Needless to say, I'm keeping my fingers crossed for Obama's health care bill to pass. My life very well may depend on it one day.
I don't have health coverage. I simply hope I don't get sick.
The lowest plan I can get around here is over $800/month. I can't afford it.
When I relocate to MA, I've found a couple of affordable plan sin the $129/month range with good coverage, low copays etc.
Right now — I have nothing. That's why I worked with my representatives on getting health care reform passed.
PS I completely agree that insurers can't be trusted with our health — period. I had a brain tumor in my 20's that was removed, and the insurer tried to wiggle out of it, claiming they weren't satisfied it was a "life-threatening condition".
In college, I worked as a temp for several major insurers, and the policy was to ALWAYS reject the claim the first time, no matter what. Don't even read it, if it' the first time the claim is put through, reject it. They figured 75% of the people who are rejected can't be bothered to argue, so they save millions of dollars per year. While I temped, several agents were fired for putting legitimate claims through the first time.
Kathy, the difference is geographic. My rate is based on zip code and age. And these were just quotes. Who knows what the final number would be once all the other factors are added? But I think living in a metro area had a more positive effect on the premium.
Katharine, I was giving them the benefit of the doubt. I agree. Insurance companies don't look out for us. It's not their jobs to. It's their jobs to sell us insurance and turn a profit. Their mistake came when they marketed to us as entities that were there to look out for our health. They're not.
Devon, I hear you. I went a few years without coverage (and I was pregnant at one point in that time). It's scary. It's like playing a game chess with your health and you're a beginning player. Scary stuff.
Lori mentioned being pregnant without health insurance. It's amazing how few individual plans even have maternity-related coverage these days (funny how a lot of policies don't cover birth control but will pay for Viagra).
For years and years my kids and I were in Devon's position… we kept our fingers crossed and used emergency rooms. Fortunately we got away with it.
I'm on medicare now and it's great.
The whole so called health insurance debate makes me furious. We need and deserve single payer like Canada, England and Mexico.
Until then we have to muddle through with what, 40,000 people dieing a year because of no insurance.
Sigh
Anne, Canada's model is pretty pathetic if you happen to live outside a metropolitan area. Friends who live there tell tales of people dying in waiting rooms.
England loves their healthcare. They should. It's excellent from most accounts.
When I worked for a temp agency, we were offered healthcare (REAL healthcare, not a discount plan) after a month and a half of service. That was really nice as it gave us the same rates the average American employee might pay for an HMO. I was fortunate – I didn't need it. But it was nice knowing the option existed.
Great comparison Lori. The biggest concern that I had about the plan was the fact that people might think it constituted creditable coverage as far as HIPAA was concerned–especially since they promoted the "No pre-existing conditions exclusions" point so heavily (which is not exactly true either)–and think that it would help them avoid a 63 day break in coverage. It's likely that many people with pre-existing conditions are already aware of HIPAA but hopefully those who aren't will check with a local agent before leaving COBRA or another plan for it.
I wish I knew the magic answer to health insurance. I could retire. I spent 30+ years in Corporate America in employee benefits/health insurance and left last year to freelance as a writer. I recently moved from San Diego to Boise (long story!) and the whole health insurance has been quite the journey – even with my 30+ years of experience.
I was on my former employer's COBRA HMO plan in CA. When I moved to ID I knew there wouldn't be an HMO available but my former employer offered a PPO plan (for over $950/month!) or a Health Savings Account (HSA) for about the same $$ as the HMO. Even though I called long before moving I was given bad information & told that I could have the HSA coverage. After paying 2 months of premium when I asked where my ID card was, I was told for the 1st time that Aetna's HSA wasn't approved in ID so my only choice was the $950+ PPO. Hey, I may be a good writer but I don't make that kind of money to pay that for health insurance.
Long story short I dropped COBRA and went with an individual HSA plan with a $2,500 deductible. One strategy is to supplement those plans with Hospital or Accident plans that are low premium but will help defray some of that high deductible. But Yo is right, thankfully, I did not have a pre-existing condition. Because HIPAA's "creditable coverage" does not apply on an individual plan if you were eligible for COBRA. So, if I had some pre-existing condition, I would have no coverage for treatment of that condition for 12 months.
The whole thing is crazy. I am working on putting out a new business blog-one focused on health care.
Everyone's health insurance needs are unique but it is definitely BUYER BEWARE. DS's health insurance is really not insurance but just a discount on health care, as noted here. For some, who don't have a high need for coverage, it may be better than nothing. But make sure you know what you are getting into and ask for help!
Thanks for letting me ramble. We have to support each other.
Right now I'm on COBRA coverage but that ends in a few months. I tried looking at individual plans, but NONE of them cover maternity & it's entirely possible I'll get pregnant again… and then what? I had an emergency c-section & was in the hospital for a WEEK. Not to mention all of the prenatal care due to gestational diabetes. Another pregnancy like that would bankrupt us.
Hubby does have coverage, but due to the industry he's in, it's high-risk occupation coverage. Which means a whole lotta money each month for family coverage.
I can cover my son through the state & it's the only way we can afford it. I will probably have to let my coverage lapse after the beginning of the year.
If I could incorporate, I'd probably be able to get better coverage. But that's also an expensive option.
Health coverage is great for people who work for companies, but the rest of us are just told to pound sand.
I strongly believe that insurers should not be able to deny coverage due to previous conditions. If they can't do it for group coverage, they shouldn't be able to do it for individuals.
Yo, exactly. I believe this one falls between the HIPAA cracks.
Cathy, I think your next book should be on healthcare – seriously. An insider's view of why healthcare is a full-blown crisis. And how to navigate it (if it's that tough for you, we really need the help!).
becky, worse is the companies won't cover birth control pills. So they won't pay for all the pregnancy and complications, nor will they help you remain, shall we say, without child. Where does that leave you besides abstinence and hey, that's not an option!
Where does that leave you besides abstinence and hey, that's not an option!
Particularly when the insurance company IS sending your husband Viagra…
LOL! Good one, Katharine! Though I hear that's not covered, either….
Anne, I couldn't disagree with you more. Medicare is bankrupt. Medicaid is bankrupt. Social Security is bankrupt. The post office is bankrupt. The government cannot print money forever and get away with it. This country is headed over a financial cliff of epic proportions, and we will eventually have a depression that will make the 1930s look like a school dance. All the government has done with the bailouts is postpone the day of reckoning. The attitude of those in Washington is to keep pushing the problem into the future so that they will get reelected.
Universal health care is simply one more nail in the coffin. There is no money to pay for this and there never will be. Our current unfunded liabilities exceed $100 trillion. I'll make you a deal. You tell me where that $100 trillion is going to come from, then I will support universal health care. Until someone can do that, the legislation should be killed.
Jeff, thanks for your post. To be completely fair, our current system of healthcare is a debacle. Over 44 million uninsured. Insurance companies, in the business to profit, do in fact profit while Americans scramble together enough money to see a doctor. Companies can't afford employer-sponsored healthcare. Employees can't afford individual plans. It's a hot mess made even worse by related factors – medical malpractice premium rates that are in some cases nearly half a doctor's income. No cap on malpractice lawsuits. Workers' compensation being flooded by uninsured who need someone, anyone, to help defray the cost of medical care. It's a spiral that started long before I wrote my first article on it back in 2000.
Yes, the government system has its issues. But the system is still in place and people like my parents still receive benefits from Medicare. I totally agree that it's a failed system.
In reality, we're not headed over the cliff – we're over it and in quick descent. But to say a government-run plan is a bad idea is short-sighted. Insurance companies make exponential profit from the sale of insurance. They don't hide the fact and they'd never deny it. But the for-profit healthcare system is not working. Taking healthcare from a for-profit business to a non-profit government system is one way to curb the rampant costs.
But it will also require an overhaul of the medical malpractice situation, too.
So if not a universal health system, what? I hear so many detractors of government-sponsored healthcare, but no other solutions. Any ideas?