Health Insurance Coverage

I had someone post a comment on a thread that I started in a forum that I’m a member of, and I thought this question was very valid. A fellow nurse was interested in becoming an independent contractor (IC) and stated that it is very difficult to give up the health benefits that are offered at her current facility.

She made a very valid point and this is certainly a concern for anyone who wants to become a small business owner or independent consultant-in any industry.

There are definitely ways around these issues as many IC’s have had to make some type of arrangement, especially if they leave their job that was offering a health plan. I won’t go into too much detail, but will discuss a situation that I was confronted with not that long ago.

My wife took a sabbatical from her full time job to pursue  a consulting opportunity. She of course carried the benefits seeing as it was the obvious choice being a self employed nurse. As I’ve mentioned, I have three small children, so health insurance is a must. Now, I’m not necessarily promoting this site, I have no affiliation, but wanted to share it with you. I’m sure most of you are aware of this site, but I went to and sifted through various options, finally picking a plan that met the needs of my family. My wife and I are fairly healthy (just wellness visits), the kids were on an annual wellness check up schedule, and we wanted to make sure to cover ourselves for any catastrophic issues that could arise.

Basically, you have to decide what type of plan you would need, and some questions to ask are:

Would you establish a HSA (Health Savings Account) to put in pre-tax dollars for routine visits, Rx., etc. for an inexpensive high deductible health plan (HDHP) that included hospitalization and would kick in once the deductible was met? Or if you have a family (kids that see the PCP often), then you may have to opt for some type of HMO/PPO with a smaller co-pay per visit, which the premiums are obviously more expensive, but the coverage is very similar to an employer plan. Keep in mind that these are typically tax deductible if you’re a small business owner, but consult your accountant or do your own research to ensure your compliant with the IRS rules. We chose a high deductible plan that offered wellness visits at no charge, along with several discounts for services like lab work, x-rays, and specialists. We had a max out of pocket per year, and the monthly premium difference was deposited into a HSA each month. (the difference between a high premium HMO plan vs. a HDHP) 

The benefit of this particular HSA account was that we had control over it, although there was a list of “approved expenses,” but it was used to cover office visit co-pays, urgent care visits, and even medications (it did come with a prescription plan). Now, the difference with this HSA plan as opposed to some of the plans offered by your employer is that it wasn’t one of those “use it or lose it” plans. If you cancelled the insurance and the HSA along with it, you were able to convert the proceeds into an investment account, or cash out. With either decision, again, please research the tax implications for both.

If you have a spouse or partner that works full -time and is eligible for benefits, then this of course may be the best option.

There are also ways to create a “group” plan as well. Many IC’s (in various industries) create a group or some type of umbrella organization so that they can all come together and receive group benefits; most importantly at group rates.

Here is an example of what I’m talking about on the “group” aspect of things:

This organization is based in NY. I actually belong to it (free to sign up), and one benefit I get from them is a discount on my cell phone bill, but I know we’re talking health benefits here. I’m attempting to create enough buzz and get some interest from other nurses here in my own state as it would be great to offer a group plan to other healthcare professionals that are independent. Just another way for us to collaborate.

Think about this too; businesses get a discount on their insurance premiums if they have a wellness program. Who better to run a wellness program than a nurse!? You could essentially set up a wellness program within this umbrella organization and receive further discounts, although many plans do offer some type of program already.

As always, do your research. Don’t sacrifice your own health. You can’t expect to provide the best care to your patient if you’re not receiving the best care for yourself.

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