Health Insurance Doc

Health Insurance Doc

Health Insurance for Entrepreneurs and Self-employed
Health Insurance Doc

Health Insurance Doc is a FlexSite. Read the content in sequence on this page … OR …

Use the Table of Contents, directly link to the topic most important to you at the moment.

The Table of Contents is repeated at the bottom of each page to make moving from one topic to topic simpler.

Health Insurance Doc Table of Contents


Do need health insurance?

Consider the official CDC data for visits to the ER (does not include Urgent Care Center) in 2013:

  • Total number of visits to ER: 130.4 million
  • Number of injury-related visits: 37.2 million
  • Number of visits per 100 persons: 41.9
  • Number of emergency department visits resulting in hospital admission: 12.2 million
  • Number of emergency department visits resulting in admission to critical care unit: 1.5 million

Summary Statement?  Nearly 1 out of 2 of us (41.9 %) will wind up in the ER during the year.  CDC breakout data reports 1 out of 4 children and 1 out of 5 adults wind up in the ER each year. Click for link to the CDC article.

Health Insurance Marketplace Plan Must Be Carefully Compared
Health Plan Must Be
Carefully Compared

Been There. Done That.
My personal experience on December 23, 2010.  NO SYMPTOMS just a sense of something not right. Drove 5 hours to WakeMed in Raleigh. 15 minutes in Cath Lab. 7 hours in open heart surgery for a quadruple bypass, 2 days in critical care, 3 days in cardiac unit, and 3 days in hospital’s “rehab” hotel.  Insurance result?  A hospital bill slightly over $100,000.  My share of bill?  ZERO!

What do you think? Was $363/month worth it?  What if I were self-employed and could not run my business?

Insurance of all kinds is all about minimizing RISK. The Health Insurance Options Comparison Appointment enables you to compare the degree to which your current or planned health insurance compare to other options in the marketplace.  You can schedule your appointment at any time by clicking this button.

Health Insurance Overview

Knowing your options is what leads to better health insurance doc decisions
Health Insurance Doc
Presents Options

The Health Insurance Market is complex (read confusing). A few demographic groups have a natural best option.

If you happen to be eligible for Medicare now or will be soon, get it without a second thought. What you need to compare is the coverage, cost, and networks offered by the Medicare Supplement options available to you. I am not an authoritative medicare supplement resource.  You are looking for someone who wil enable you to COMPARE the options in your marketplace. All options are NOT necessarily right for YOU.

If you are not of Medicare age, ObamaCare (ACA) is your first (not necessarily best) option to review. I take particular care in doing this during our Online Health Insurance Options Comparison. Why? It is a great option if you happen to have pre-existing conditions and low household income. This is true IF good Networks are available where you live.

ACA costs (premiums, copays, deductibles, coinsurance) are  strongly influenced by household income and the number of dependent persons to be covered.  At the lowest ACA rates, choice of doctors, hospitals, and networks are limited. Typically, you will be restricted to an EPO or HMO network. As of early 2017, the “Silver Plan” often proves to be the best deal. You want access to as many doctors and hospitals as possible. Not all are of equal quality.  Choose Well.

As household income increases and the number of persons to be covered increases, your premiums, copays, deductibles, maximum out-of-pocket limits, and post-deductible coinsurance increase. ACA suddenly can become a poor option, particularly if you are in good health. You MUST compare your options. This is not a “maybe”. It is a MUST. Believe it or not, there are Zero/Low Copay and Zero/Low Deductible options out there at significant savings over ACA.

Health Insurance Options

Your best Health Insurance Options must provide the right answers the following questions:


  • What combination of Premiums, CoPays, Deductibles, and Coinsurance after Deductibles is RIGHT for you?
  • Should you join/stay on your spouse’s work insurance?
  • Should you stay on your previous company’s insurance plan using COBRA?
  • Is the public insurance option (ObamaCare/ACA) the path for you to take?
  • Should you get one of the private 90-Day Short Term policies, even though you must reapply and re-qualify from scratch every 90-days?
  • Should you get one of the private association-based group plans that you can customize to your situation, coverage needs and budget?

The key point here is THERE ARE OPTIONS! In the final analysis, does your health insurance cover your RISKS within your BUDGET? Is your health insurance a stabilizing force in your business and personal financial life IF you suffer a serious accident or illness?  The answer to this question MUST BE YES.  Experience shows that well-planned health insurance can become business continuation insurance and financial stability insurance.

A Health Insurance Options C0mparison Appointment is designed to answer these questions. If you want to schedule, you can click the button below at any time.


Health Insurance Comparison 


  • Health Insurance Doc Comparisons Count
    Health Insurance Doc Comparisons Count

    You schedule an appointment at a time at which you can be at a computer.

  • Complete the pre-Appointment form. Your answers to those questions enable me to effectively prepare for our conversation.
  • I will call you at the appointed time and make it possible for you to see my computer screen. Why? You get to view the same official information that I do at the same time.
  • We review both your public and private options. My role in this process is as an ADVISOR not as a salesperson. (I know that sounds weird but it is a fact.)
  • We examine coverages, costs, and networks. (Be sure to read the Topics and Terms section before our appointment.)
  • Our comparison conversation may be as brief as 10-20 minutes. If you identify a BEST OPTION I’ll either refer you to the public or private source of that option … or … I will review the details of that option. If YOU judge it to be your BEST OPTION, I’ll process your application.
  • That whole process can take 60-90 minutes. It always passes quickly because the issue is important to you.
  • If you will be making a joint decision with a spouse, it is best for both to hear the same information from me. If there are questions, I want to be able to give the answers.

In summary, having no health insurance is a terrible idea. Making a sound choice on coverage within budget requires that you compare your OPTIONS.

I do not charge for this consultation.  Why? It is the right thing to do. Without the ability to objectively compare options, anyone is defenseless in the health insurance marketplace. Only by objectively comparing your options, can you identify the coverage, cost and network that is RIGHT FOR YOU.

If you are ready to set an appointment to compare, click the button below:


The Health Insurance Doc is a former teacher and trainer.
Don, the
Health Insurance Doc

Yes, my doctorate is in Education. I have taught at the high school, undergraduate, and graduate levels in both public and private education.  I have trained and consulted in the private sector from sole-proprietorship through Fortune 500 levels. Advising on health insurance is the same thing I have been doing for decades. I first earned my health license in 2002. Whether in education, business, or insurance by job has been to help Clients make better decisions.  My commitment to you, as your Health Insurance Advisor, is to guide you through the chaos that is the health insurance industry today.  I can’t straighten out the industry but I can smooth your road to identifying the best health insurance that meets your coverage needs and budget.

Health Insurance Topics and Terms

Insurance payments are delivered to providers through “Networks”. Networks contract with doctors, hospitals, and service providers for a discounted rate based upon the volume of business they provide. Those discounts are passed on to you. There are three types of Networks that you will typically encounter.
PPO (Preferred Provider Organization)

These are the largest. Their health insurance plans offer greater choice than HMOs and EPOs. Subscribers receive the greatest benefits from In-Network providers but are free to use Out-of-Network providers.
HMO (Health Maintenance Organization)
HMOs are more of a regional organization that often owns their hospitals and facilities and the doctors, nurses, and staff are employees. They require subscribers to use their resources. Often, subscribers are required to get a referral from the assigned primary care doctor.
EPO (Exclusive Provider Organization)
EPOs do not cover care provided outside of their network.

There are five types of costs that a subscriber will encounter.
Premiums are the basic monthly cost that you pay for your insurance.  Your premium amount is typically not tax deductible. There may be situations in which your unreimbursed medical expense are above 10% of your Adjusted Gross Income (AGI), that they may qualify.
Copays is one of the ways in which a patient share in the cost of specified medical services. The insurance company pays the rest. Indemnity Plans often pay an amount that covers the total amount that a patient would ordinarily pay for doctor visits.
A Deductible is the annual amount that an individual must pay for before any charges qualify for benefits.  Some policies have a “Family Deductible” that is less than a number of covered members times the individual deductible.
After an annual deductible is met, patients often share in a percent of a providers charge for services. 80/20, 60/40, 50/50 are most frequently used.
Out-of-Pocket Max
That is the maximum you pay for your medical expenses during a year. Premiums are not included in that calculation.

Each of the above costs in a policy must be compared to your other options. It is possible to have a low premium but very high deductibles and out-of-pocket limits.

Health Insurance for Self-Employed

The Health Insurance Doc is a former teacher and trainer.
Don, the
Health Insurance Doc

Health Insurance for Self-Employed is a huge issue. It starts with whether should you be a C corporation, an S Corporation, an LLC, a Partnership, or simply filing with an EIN. For an authoritative answer versus an opinion, you want to ask your accountant why which Tax Status you choose matters.

The most important starting point is to reflect upon the fact that many billion dollar corporations such as Microsoft, Apple, and Amazon started as home-based businesses. Garages, basements, laundry rooms, attics, and spare bedrooms have spawned millions of success stories. Your story just might be the next to hit that list. One common characteristic that each of those three shared is an unwavering belief in themselves. Another is WORK. And, the third, an organized effort.

Whether you focus on making a few hundred dollars a week, a few thousand a month, or making a million dollars per year, that goal becomes a mission that your health insurance must support. Coverages and costs are always an issue.  Click for more about Self-employed Health Insurance page on this website.

Health Insurance Doc Responsibilities

Health Insurance Doc Comparisons Count
Health Insurance Doc
Comparisons Count

Health insurance is of unique importance to  entrepreneurs, 1099 contractors, self-employed, and small business owners. WHY?

What happens if you are laid up and cannot work?

What happens if illness or accident recovery expenses are beyond your budget?

Serious accidents and illness are unexpected emergencies. You don’t plan for them to happen. You do plan to be able to handle the RISK that they impose. Why? Your business goals could go on hold temporarily or permanently if you do not have a source of support funds.  History says your health insurance can easily become your business continuation  insurance or your financial security insurance. Insurance is all about preparing for unexpected risks. Why do you buy car insurance and home-owners insurance?  Insurance is all about the “IFs” in your life. Properly designed health insurance coverage is a must for the self-employed.

Health Insurance Doc and Your Options

Knowing your options is what leads to better health insurance doc decisions
Health Insurance Doc
Presents Options

When it comes to health insurance, there are lots of options. BUT, not all of those options are RIGHT for you and your budget. That is my value to you as an ADVISOR versus a salesperson. When working with you, my responsibility is to know what I am doing, to ask the right questions and listen carefully to your answers. I then need to explain the options available within your budget. One of those option may be leveraging HRA 105 to maximize your income tax deductions for your health insurance expenditures.  Click this link to learn more about HRA 105. 

Health Insurance Doc Website

How much health insurance is a question answered by budget
Essential within Budget

Think of this website as a basic introduction to health insurance. Most people I talk with have business interests. Fact is, having a financially smooth running family is a significant business accomplishment.

CLICK THE BUTTON below to arrange your Health Insurance Comparison. Schedule your appointment at a time when you can be at a computer. I want you to be able to see what is on my computer screen. WE are in this together. Be sure to answer the few questions you are asked on the survey form. Your answers help me to properly prepare for our comparison session.