Personal Health Insurance in Seattle: What Are Your Options?

Since 2007, I have paid for my own health insurance. As a project temp, my contracting agencies typically provide no insurance, and when they do the coverage is often fairly limited with low deductibles but also low maximum coverage. In other words, if you get in an accident or develop cancer, you may as well have had no insurance at all... all for the low price of $25-30 a week lopped off your paycheck.

Affordable health insurance options for the average working class Seattlite come with similar limits. The cheapest options available provide much higher coverage ceilings than the aforementioned low end plans... but they also come with a high deductible, various usage limits, and when you are covered the plan only co-insures part of your initial covered expenses. Still, for a Seattlite who doesn't have employer-subsidized health insurance, it's the best, most affordable option out there.

The two most accessible providers are Lifewise Health Plan of Washington and Regence Blue Shield. I initially paid for insurance with Lifewise as they had the lowest cost. But as Lifewise's catastrophic premium charges rose, along with the level of their deductibles, Regence became my top choice late last year.

The cheapest plans come with high deductibles, meaning that aside from basic checkups and doctor visits, you must incur and pay in full any additional medical charges up to the amount of the deductible in that calendar year before your plan covers you at all.

In Lifewise's case, the cheapest plan (which for a 30 year old adult would run over $130 a month) typically comes with a $3500 deductible, meaning you're on your own for the first $3500 in non-routine medical expenses before the plan covers you.

But even beyond that, you're not necessarily covered. If your plan entails a 20% co-insurance up to a certain point, as Lifewise's $3500 deductible Wise Essentials does for up to $5000, then the plan only pays 25% of your expenses, while you're on the hook for the rest until you've incurred another $5000 in personal expense. Granted, once you pass that threshold in this case, Lifewise covers everything, so if you, say, develop cancer and ring up $100,000 in medical bills to treat it during 2009, you're only on the hook for the first $3500, plus 25% of any subsequent expenses until you've paid $5000. But you still need to find a way to pay off $8500. Good luck with that, though it beats a bill for $100,000. And for any treatment in 2010, you need to ring up another $8500 before you're fully covered for that year.

These plans are often referred to as catastrophic plans. They don't come into play unless something catastrophic happens to you medically, and then they cover a good portion of your expenses. You could get a more comprehensive plan, but these are typically very expensive, costing at least $200-300 a month. The catastrophic pans may be your best, most viable option.

In Regence's case, they offer HSA plans, which are similar to Lifewise's Wise Essentials plans except they offer you the chance to open a Health Savings Account on the side. You can deposit money on a regular basis into this Health Savings Account on top of your cheaper monthly premiums, and use those HSA funds to pay for medical expenses that your insurance plan doesn't cover. Plus, even if you use your account to pay medical expenses, those count towards your deductible. If you have a $2500 deductible on a plan and 20% co-insurance up to $5000, but have $7500 in your HSA, then in essence you're fully covered for the year! You just pull money from the HSA when you're not covered.

Granted, you'd rather not be ill or injured enough to enter such a situation. And finding $7500 to put in your HAS, even over time, is easier said than done. But having that level of personal coverage or anything close to it gives you peace of mind that even a full health insurance plan subsidized by an employer may not give you.

Both Lifewise and Regence do offer plans with lower deductibles and more comprehensive coverage, but they prove far more expensive, often costing a 30 year old adult hundreds of dollars a month. Such a plan is so cost prohibitive that it may prove more worth your while to go the HSA/Catastrophic route if you can stockpile the needed money in your HSA.

People with chronic conditions may require full health insurance, which can get very expensive. Hopefully, you're not in this boat and rarely, if ever, need to see a doctor for anything because you're in good health. Most cannot afford health insurance on their own and often do without. But such a low-cost plan may be a smart option for an uninsured worker in Seattle that doesn't have the budget to pay out the nose for full coverage.