One of the most intimidating parts of leaving my traditional job for self employment was losing my insurance. Paying $300+ a month for coverage didn’t make sense for me financially, so I started looking for alternatives. I did a lot of research, and there was some trial and error as well, but here’s what has worked for me!
Indemnity Plans: An Affordable Base Layer
I use an indemnity plan that costs me $111/month. It’s been the best fit so far. This option does force you to do a bit of research as you search the best prices for services, so definitely keep that in mind. Here is what is included in my particular indemnity plan:
- Emergency Care
If I need to go to the ER the plan offers a certain amount of money for the visit and a certain amount per day for hospital stays. I’ve not needed to use this part of the plan yet, but I have the peace of mind knowing I have SOME coverage in the event I need it. - In-Patient Stays
If I’m hospitalized, the plan offers a certain amount per day up to an annual limit. - Doctor Visits
I receive an $80 reimbursement per visit for up to 20 doctor visits per year, 2 of which can be specialists visits reimbursed at $100/each. - Preventive Care
I receive a flat $250/year reimbursement for preventive care. I typically submit a claim following my annual physical, but have also used it toward my flu shot before. Just keep in mind, it’s one preventive item total per year. For Xrays, I believe you can get $80 back- I’m sure there is a limit to how many per year, but you can source the lowest cost in your area on an x-ray and receive $80 back on that. The same goes for an MRI at $300 and Mammogram at $250. I believe a colonoscopy receives $500 every 3 years. [Note: these prices can change at any time with the company, so may not still be this at the time you are reading]. - Prescriptions
I’m not sure what the limit is on prescription benefits, but my plan allows $10 reimbursement for generic medicines, and $20 for name brand ones. - Telehealth (included free)
This allows online doctor visits, usually within an hour. This is a great option when you might know what’s wrong with you but need confirmation and a prescription. The fact that it’s a free online visit is nice as well, because it allows you to have a starting point to know if you need to pay for an in person visit.
Always ask care providers for a “self-pay” or “cash rate” when booking. A physical for me costs $175 out-of-pocket and I get $250 back from my indemnity plan.
Affordable Lab Work Options
When paying out-of-pocket, labs can be surprisingly affordable. Here are my go-to resources:
- Local hospital
Check your local hospital website to see their prices for certain labs. They should have a list of ones that are pretty standard and are affordable. My $250 annual preventive care reimbursement typically covers my physical and most of my lab work. - Walk-In Lab
Places like this typically allow you to create your own lab order. I can take the order my doctor provides me and create the same order through these websites. Then I take the order into LabCorps and they do the lab work for me. Once the results are posted in your account, you have the option to fax them directly to your doctor.My link to Walk-In Lab is an affiliate one they offer all customers within their portal. It basically just gives you a discount, and gives me reward points toward gift cards I think.
Mental Health: Therapy On A Budget
If you’re looking for affordable therapy, I highly recommend Open Path Collective. You pay a one time membership fee, and are given access to therapists charging $30-$60. I found my therapist on there and it cost me $30/session for the first year. I’ve since raised what I pay a bit (my choice), but it is still under the $60.
My indemnity plan has reimbursed these visits as part of the 20 yearly allowed as well. If I submit a claim every other therapy visit, I make most of the money back on those visits. If you plan to submit claims, keep in mind it is part of your 20 visits for the year!
When choosing my therapist, I went through the list of options and found 3 that seemed promising. I then scheduled a short call with them to discuss my goals, and from there I made my decision. I was able to tell pretty quickly on those calls who would be the best fit for me, and I’ve stuck with my therapist for 5 years now!
Direct Primary Care
When I first started my business, I used a Direct Primary Care (DPC) practice that cost me about $75/month at the time. I believe now they run more like $90-$120. At the time I had several things I needed like a physical and to figure out some breathing issues I was having. Direct Primary Care was great then. I recommend that if you DO use DPC you also have some sort of indemnity plan. I ended my DPC after a year though and now just use the indemnity plan.
Even now, I still use the self-pay pricing insights I learned from DPC. Many specialists charge around $200 without insurance—which was around the same amount I was on the hook for when I had insurance and went to a specialist.
Direct Primary Care typically include:
- Unlimited visits with no copays
- Annual physicals
- Help finding affordable specialists
- Longer appointments due to the ability to spend more time with the patient since they take on a limited number per year
Note: DPC works best alongside an indemnity plan for emergency coverage.
Prescriptions: Save with Discount Cards
I typically use GoodRx to find the best cash prices at local pharmacies. Others have also recommended Mark Cuban’s CostPlus Drugs – which appears to be great for long-term and name-brand meds.
Dental Care
When looking into dental insurance, I found it was pricey per month. I checked the websites of a bunch of dentists in my area (ones with good reviews), and found that dentists often offer an annual plan for uninsured patients. I chose one that charges $300 for the year, and with that I receive a cleaning and x-rays twice a year. With this plan you also receive a discount for any other services you might need such as fillings.
Dedicated Savings Account
I try and put aside a little but of money that is just meant to pay for cost of appointments I might have. I know going into the year that I’ll need to pay out of pocket for a physical, lab work, mammogram, dental care, and of course any sick visits. If you call your providers and ask what their self-pay rate is you’ll have a pretty good idea of what to budget! I know I’ll have to pay out of pocket at first, but I’ll receive money from my indemnity plan for things like the physical, lab work, mammogram, and sick visits. Even putting aside a small amount can give you peace of mind knowing you can get care when needed.
In short, here’s the strategy I currently use:
- Indemnity Plan – $111/month
- Telehealth – included in my plan
- GoodRx – for prescription discounts / can submit receipts to indemnity plan for small reimbursement
- Open Path Collective – for mental health
- Annual Dental Plan
- Emergency Fund – set aside for unexpected, high-cost events
Personally, I know that any huge diagnosis can bankrupt the average American, so I use these steps to prepare the best I can without spending $300+ per month on insurance. With a bit of research you can design a plan that gives you at least a little peace of mind.
Disclaimer: Any of these prices and benefits can change at any time- such is the current healthcare market. I hope these items will be helpful to you though, as you attempt to piece together you’re own healthcare plan. Making sure you’ve got some coverage available in an emergency is important- as is preventive care!