insurance for self-employed question

Discussion in 'General Parenting' started by Ktllc, Jul 26, 2012.

  1. Ktllc

    Ktllc New Member

    The good news: we are making more money as the business is growing.
    The bad news: Sweet Pea will lose her state insurance in September, V and Partner will lose theirs in February.
    I have a high deductible policy ($5,000) and it does not cover behavioral health. sensory processing disorder (SPD) is likely to be an issue as it is often not considered a medical condition.
    If I smply add the kids to my policy, the deductible will be $10,000. After that only 20 sessions of speech and Occupational Therapist (OT) will be covered....
    Does anyone knows of any good insurance provider for difficult child requiring therapies? I will be digging and reading all those fine prints, but some pointers would be greatly appreciated.
    From what I've seen so far on the net (quotes), it probably will be better to purchase an individual policy for V. If I find a good health insurance carrier that covers everything (social worker, social skill group, Occupational Therapist (OT) and speech), we would than explode the deuctible and then get everything covered. We'll have to seriously budget though.
    Sweet Pea is doing much better in speech so I'm hoping she might not need therapy for much longer anymore.
    Transition periods are never good.... And then, don't get me started how gross income is calculated for self-employed people! A freak**g moron wrote those guidelines. The lease on a truck is not an expense... yeah, try to run a transportation company without at least 1 truck! $1700/month: not an expense???
    Ok, let's not fight windmills and let's try to be practical.
    Problem: insurance for the kids.
    Solution: ???
     
  2. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I dont know about insurance but if you make less than a certain amount you qualify for medical care through UNC. I realize that would be quite a ride but it might be worth it rather than paying $10K. You can look up online what the income limits are. Its UNC Medical.
     
  3. hearts and roses

    hearts and roses Mind Reader

    If you join your local chamber of commerce, they offer health ins to small businesses at fairly reasonable rates.

    Not sure where you are but here in ct anyone can join the state health plan-it's based on a sliding scale rate schedule so the more you make the more you pay but because it's a state insurance nearly all those services are covered, at least to some degree. I'm not sure if they've restructured it since the ACA changes that occurred in January 2012, but it may be worth contacting your state's office.
     
  4. DammitJanet

    DammitJanet Well-Known Member Staff Member

    That may be true too but NC has some bassackwards laws. I am not sure if the new guidelines are online yet. Probably not since most of them dont take place until 2014. I believe the UNC Medical was almost 30K for a famiy of 2. Dont know what it would be for a family of 5. But yes, you can pay down on the Healthy Childrens I believe. I also believe you can do a spend down on medicaid. Check that out. Ask a caseworker. Obviously you could easily do a spend down if you are talking about that much money. Im really trying to think for you. Call NAMI and ask them. They may know of some insurance companies that would be good for this type of thing.
     
  5. Ktllc

    Ktllc New Member

    My first move was to call our case worker and you cannot buy into medicaid. Health choice (higher income) is only for children over 6 years old, so although we used to qualify under Health choice guidelines, the kids still received medicaid because of their age. I will be able to buy into Health Choice for Partner, but not V and Sweet Pea.
    NC has a waiver for special need kids but the waiting list is VERY long (I think we are talking in years but will call today and see if V can be put on it sooner rather than later).
    If V gets diagnosis with Autism Spectrum Disorders (ASD), I'm not sure how it would impact getting private insurance... I know they can discriminate kids based on pre-existing condition but how about the rate? Can they make it so high it won't be affordable?
    Our local chamber is very small and I have not seen any health coverahe on their website. I will call and double check though. They might at least offer some ideas.
    I've looked into buying into NC state coverahe and have not seen anything like it overhere...
    Please keep the ideas coming!
     
  6. DammitJanet

    DammitJanet Well-Known Member Staff Member

Loading...