Self-Employed and Choosing Health Insurance


Welp, we did it. Starting October 1st, we got on our very own health insurance plans for the very first time ever. Before this point, we’ve always had an employer offering us plans and subsidizing the costs. But now that we’re 100% self-employed, we’re 100% in charge of our own health, too. We discussed it in this post recently, but just to recap, we’d been looking at a few health insurance options, traditional ones and one called Christian Healthcare Ministries, which was very untraditional.

Finally, one night in a moment of utter nerdiness and desperation, Johnny busted out a spreadsheet of our options and all the different scenarios we were considering. Here’s how it went down:

How We Calculated

Johnny did all the legwork for this, so first let me give him an Internet pat on the back. Well done, good fellow. With spreadsheet at hand, he started hypothesizing how many times we’d each need to see a doctor this year. Odd, yes. Necessary? Debatable. Fun? Kind of. It was like guessing which of us would survive our Oregon Trail trek and which of us would perish from cholera or snake bite. Johnny and I are fairly healthy, so we guessed we would only need to see a doctor twice each. We took a stab and said Sally and Wynn would need five doctor’s visits, not including well-visits. Add in the five well-visits between the two of them and that’s a whole lotta office visit costs.

After projecting how many visits we’d each need, he then got on the phone and started getting quotes. With monthly premium costs, copay costs, and deductible numbers in hand, he then plugged those numbers into his spreadsheet and compared the costs of the different plans.  He calculated the costs of our whole family on a traditional healthcare plan, all of us on the healthcare ministry plan, as well as a cost analysis of combo plans (some of us on traditional and some on the healthcare ministry).

What We Decided

After doing more math than is humanly enjoyable, we opted to put the girls on a traditional health insurance plan and ourselves on the Christian Healthcare Ministries plan. We chose the highest eligible plan for ourselves with unlimited “coverage,” and it will cost around $320/month. We have a $500 deductible of sorts that we need to reach, and then any and all bills that exceed the $500 price point are covered 100%. Not too shabby. Sally and Wynn’s traditional plan will cost us about $290/month. Their plan has a low $250 deductible and a $5,000 max out-of-pocket cost. The kicker, though, was that well-visits are covered 100%, and all other visits have a $25 copay with a deductible waiver. If you made it through all that gobbledygook (check out our Health Insurance terms for normal folks if you need a refresher), Internet high-five from me to you. So our monthly premium for both plans will be about $600.

We feel pretty confident about the choices we made. We (okay, mostly me) were most concerned about our girls having great coverage and never feeling hesitant to take them into the doctor because of costs. When Sally had to be hospitalized in April, I’d like to think we’d have still taken her into the ER in the middle of the night no matter the cost, but I don’t want that to ever be a choice we have to debate. So we feel really good about the low deductible, low copay plan our girls will have.

We’re also excited to try the healthcare ministry plan for ourselves. It’s basically the same price as a catastrophic plan, but it offers an extremely low “deductible.” If anything major ever arises, the most we’d ever be out is $500 for the entire year. And while we’ll be paying more upfront at doctor’s visits, those tend to be fewer (read: almost zero) for us than our girls. And in the meantime, we’ll save thousands over the course of the year by having such a low monthly premium. So it feels like a win-win in theory. We’re looking forward to doing a more in-depth review and explainer on Christian Healthcare Ministries once we’ve had a chance to try the unique process firsthand.

This whole experience has been extremely eye opening as we venture into the unchartered territories of self employment. Seeing that $600 price tag is a pretty tough pill to swallow, but it’s essential and we’ll make room for it in our budget. Wading this deep in healthcare numbers and information makes us feel like much more informed consumers. It has been a good reminder that healthcare costs are like any other commercial activity: you should be able to ask your doctor’s front desk or insurance what any visit, procedure, treatment, lab work, etc. will cost you. Up until the last few months, we’ve always just chalked it up as a total crapshoot. But not anymore! Now that we’re 100% responsible for our costs, you better believe we’ll be planning and watching those costs like a hawk.

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  • Reply Gretchen October 8, 2015 at 7:47 am

    It seems like a lot of people have been going the Christian cost-sharing method! (As a side note: I’m definitely googling how much these programs have grown in the last couple of years) But seriously, kudos to you guys for doing that much math/pros & cons. I’m reading all of this at 6:30am, so I got overwhelmed, but it’s good to know that if I ever need a breakdown, I can come and get it from you, rather than do it myself…haha!

    • Reply Johnny October 9, 2015 at 10:23 am

      I’m sure you’ll find in your Googling that they’ve grown a ton over the last few years. Part of that made me think, “Score! More money in sharing pot!” But another part of me thought, “Shoot! People are figuring out ways to take advantage of the system.” So I actually called the healthcare ministry we enrolled in and asked if they gave access to their financials and sure enough, they sent me a PDF of their tax filing for 2014 and gave me the direct phone number to their CFO. Pretty cool.

  • Reply Andy T. October 8, 2015 at 8:42 am

    How does the health care ministry handle the whole child birthing thing?

    • Reply Johnny October 9, 2015 at 10:28 am

      Great question, Andy. For the ministry we’re enrolled with, they’ve got a whole section that spells it out:

      The long and short though, it’s covered to varying degrees depending on your plan. The plan we’re enrolled in (Gold w/ Brother’s Keeper) would cover pre-natal, delivery, post-natal, and any complications at 100% with no limits. But much like Aflac, your due date cannot be within 10 months of your enrollment.

  • Reply Rob October 8, 2015 at 9:03 am

    Great job planning and implementing all this stuff, guys. One can’t be too due diligent when it involves important family health coverage.

    Being a Canadian, we’re very blessed with our health care system coverage, where most of our routine expenses are fully government funded. Add to that, now that my wife and I are both retired, our former employers provided both of us with good retirement benefits whereby most of our other health – and dental – expenses are fully covered through co-insurance.

    That said, however, we still set aside funds in our long term planning for future health exposure issues (where we would have to pay perhaps a fair chunk of change) – that being the possibility of long term critical care assistance funding, assisted living support, etc. – all the stuff that retired seniors eventually need to think about when they get “really old” (not so much applicable to us however since we plan to live forever and keep posting comments to your blog)! 🙂

    • Reply Johnny October 9, 2015 at 10:30 am

      Haha. When we’re old and withered and can’t type on our keyboards anymore, we’ll turn the keys of the blog over to you, Rob.

      • Reply Rob October 9, 2015 at 11:05 am

        It’s a deal dude provided that Sally and Winnie help me out by increasing the font size on my monitor then – Arial size 35 should be about right! 🙂

  • Reply Money Beagle October 8, 2015 at 9:06 am

    Thanks for sharing your experience and your decision. This always seems very complicated for all, but when you add in that you’re now making the decision on your own, it definitely jumps to the top of the ‘complexity’ scale. Sounds like you did your homework. Please follow up to let us know how things work out moving forward.

    • Reply Johnny October 9, 2015 at 10:31 am

      It’s a mess of a system for us normal folks to understand. It shouldn’t be this difficult. We’ll definitely do a follow up here in a bit.

  • Reply Tara October 8, 2015 at 10:13 am

    Hi, I have great health insurance but currently for my husband, it was cheaper for him to go on a catastrophic Obama care plan. But we are pregnant and I did have questions about the health insurance you found your kids. Was that through the state’s Chip plan? I think in my state I can be on the Chip but have to pay the full premium since I make too much money ($214 a month isn’t bad for dental/health/vision). But if you found something different, I’d be interested in what you got!

    • Reply Johnny October 9, 2015 at 10:41 am

      Great question, Tara! We looked into our state’s CHIP plan (state-sponsored insurance for children who are uninsured, for those reading this and don’t know what it is), but we weren’t eligible because our income didn’t meet the requirements.

      I looked at first, found some providers and plans that would work for us, and then I actually contact the insurance provider directly and got quotes that way. But definitely investigate what options your state provides before going the private route. On the surface, that $214/mo premium seems like a really good deal!

  • Reply Rachel October 8, 2015 at 11:08 am

    Wow! Reading this from the UK these numbers sound scary. We are so lucky to have the NHS where health care is free at the point of delivary, in Scotland even my prescriptions are free. Next week I’ll go for my quarterly treatment at the hospital where the supplies alone cost $1500, for me it is free. Last year when my never-sick partner got a mystery illness that led to 10 doctor visits followed by a week in hospital and then more follow up visits (still don’t know what the cause was!) all it cost us was the new pjs I ran out to buy! Obviously we pay taxes and they fund the NHS, but we never have to worry about affording medical help when it is needed.

    • Reply Johnny October 9, 2015 at 10:43 am

      It’s fascinating to hear how different healthcare is outside of the US. I’d be really interested to compare tax rates with the US and the UK, Canada, and other countries (most) that cover health costs for their citizens.

      • Reply Rachel October 10, 2015 at 5:10 pm

        Yes, that would be facinating. Future post perhaps?!

  • Reply Tarynkay October 8, 2015 at 11:21 am

    Ugh, I very much dislike health insurance! Especially at the moment- we had met the $7500 deductible on ours back in February when our son needed a minor medical procedure. Then I got pregnant and we were like, yay! Free baby! Especially since our plan requires us to pay 100% until the deductible is met- no copays. After we meet the deductible, we pay 20% until we hit $10k.

    Only the baby is due November 11 and the deductible resets November 1. I therefore predict that this baby will arrive at 12:01am, November 1.

    Just to make things more fun, all of the practitioners now seem to charge one global fee, which they do not bill insurance for till after the baby is born. I have tried to get a work around or exemption for this to no avail. So we will end up paying the entire deductible again.

    This wouldn’t be so bad if we ever needed healthcare, but seriously, we always get through the year having met maybe $500 towards the deductible. We do take our son to the doctor whenever he needs it, we have never hesitated. He just doesn’t get sick. I guess the new baby might be sickly? Somehow I find it impossible to hope for that, though.

    In sum: health insurance is stupid and there has to be a better way for this to work.

    • Reply Johnny October 9, 2015 at 10:55 am

      This had me boiling with anticipatory anxiety and anger. Sooo frustrating. Obviously it’s probably best for that baby of yours to keep baking until he/she is ready, but maybe he’ll/shel’ll want to stick to it your insurance and come just in the nick of deductible-eligible time.

      Either way, congrats and best of luck as you near the final stretch!

  • Reply Michelle Schroeder October 8, 2015 at 1:28 pm

    Health insurance is definitely one thing I don’t like about being self-employed. We are thinking about going the ministry route but we’re still not sure. I’ve heard that they don’t usually cover you if you take part in “risky” behaviors, such as long-distance biking, rock climbing, and so on. Do you know how it works in that case?

    • Reply Johnny October 9, 2015 at 8:40 pm

      Good and relevant question for us, too, so I figured I’d ask. Here’s their response:

      “As long as no other party is responsible for the bills and proper safety equipment is being used then it would be an eligible expense to submit to CHM members as long as it meets our guidelines.”

  • Reply Becky October 8, 2015 at 1:59 pm

    I think you made a great choice! I think the ministry option is great for adults, but I was nervous about the girls being on the ministry plan.

  • Reply David October 9, 2015 at 5:36 am

    ‘Planet Money’ on Saturday was about a system where you get paid to have procedures, tests etc done if you go to particular places. Johnny may well have already listened to it (as I remember a post you guys did on what podcasts you listen to) but if not it may be worth a listen.

    I totally echo Rachel’s comment about the NHS being a real blessing in the UK. Never having to consider the cost when rushing to A&E (the ER) is totally worth paying the taxes for!

  • Reply Cat@BudgetBlonde October 9, 2015 at 2:26 pm

    Navigating health insurance options can be so difficult. I have heard a lot of people going the health care ministry route instead of just buying a plan off the open market. Thanks for sharing!

  • Reply Anna November 2, 2015 at 4:50 pm

    I’m very interested to see a full blog post from you guys in the future about the health care ministry. I barely knew that existed, but now that I’m looking at it a little bit… it seems like a really great option. My husband and I are young (24), and usually have very little doctor’s visits and medical expenses each year. Our insurance is outrageous through each of our work, so this looks like a good option. The maternity coverage also looks really thorough, and we’re hoping to start a family in the near future.

    Thanks for doing all the research and reporting back. It definitely helps me navigate the waters a little bit better when I’ve had it explained to me by you in layman’s terms!

  • Reply Jenni November 23, 2015 at 5:45 pm

    Thank you so much for posting this. I wasn’t aware of the healthcare ministries and have done a lot of research since reading this post a while back. We are most likely going to use Liberty Healthshare since it acts more like traditional insurance (e.g. you get well checks covered) but CHM was a contender too. We are most likely going to go with a family plan with Liberty, but I would be curious to know what plan you picked for your girls. Would you mind sharing which provider you are using? And actually, do you know if the kiddos have to be on a ACA-approved plan if the parents are on a healthcare ministry plan? Or could they go on a non-exchange plan without getting the tax penalty? I have been self-employed for 8 years now and this stuff has gotten worse each year!

    • Reply Johnny December 27, 2015 at 1:58 am

      Sorry for the delay in responding, Jenni! For our girls we picked a plan that offered office visits at copay costs without deductible requirements (I think it was called “waiver of medical deductible for office visits”). The deductible was fairly low, but our primary concern was getting a plan that wouldn’t make us think twice about taking them in to see a doctor.

      As far as ACA requirements, my understanding is that all tax dependents must be on an ACA-approved or exempt plan. So they have to be on our healthcare ministry plan OR a compliant traditional plan to avoid getting fined.

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