Save thousands on health care -- now

By Kiplinger's Personal Finance Magazine

Washington is buzzing about pending changes in the health care system, and a bill could pass before the end of the year. In the meantime, if you're losing benefits because of a layoff or college graduation, or struggling to pay rising premiums, you can still find affordable coverage.

Several recent developments could help you save thousands of dollars on health insurance premiums:

• This year's economic stimulus legislation included a health insurance subsidy for laid-off workers.

• In many states, new laws allow children to be covered by their parents' policies until they reach their mid-20s.

• And early retirees can now purchase insurance that will cover them until they qualify for Medicare.

If you're laid off

If you lose your job, you may be able to get coverage from your spouse's employer, continue your own coverage through COBRA -- the federal law that lets former employees continue group coverage for up to 18 months -- or search for an individual policy. Compare all three options: Many employers no longer subsidize coverage for family members, so adding on to your spouse's plan could be expensive.

COBRA is available to employees of companies with 20 or more workers, and you can't be rejected or charged a higher rate because of your health. But you'll have to pay the full cost yourself, which averages $12,600 per year for family coverage and $4,700 per year for individuals, according to the Kaiser Family Foundation. (See "Know your COBRA rights.")

Under the stimulus legislation, Uncle Sam will pay 65% of COBRA premiums for up to nine months for people who lose their jobs between Sept. 1, 2008, and Dec. 31, 2009.

But if you're healthy, you might still get a better deal on your own. Melissa Harrison, 32, lost her job as a horticulturist at a nursery in Summerville, S.C., in early February, just weeks before Congress passed the stimulus. She could have stayed on her old policy through COBRA, but her premiums would have jumped from $200 per month to $480.

She went to eHealthInsurance, used a tool that lists the insurance networks that included her doctor and found a policy issued by Celtic for $190 per month. The policy carries a $1,500 deductible, doesn't charge for annual exams and screenings, and offers maximum coverage of $7 million.

• How to look online for good health care

Harrison qualified for the 65% COBRA subsidy a few weeks later, but she turned it down. She would have saved only about $20 a month with the subsidy, and the price would have jumped back up to $480 after nine months. Plus, she liked the Celtic policy better -- especially because she had been paying out-of-network charges to visit her doctor under her employer's plan.

Harrison concedes that it's tough to focus on shopping for health insurance when you're worrying about finding work. "But my mother drilled into me that you have to have insurance," she says. "If you have a little time, you can get a better deal than COBRA and find a policy that fits you better, too."

• Compare insurance quotes

If you're older

Premiums will be pricier if you're older or have medical conditions. Laura and Shaun Best of Stevenson Ranch, Calif., own a locksmith business specializing in bank security. The couple also have three kids ages 13 to 20. The Bests have had their own health insurance for a long time, but the premiums kept creeping up. When they reached $929 per month, Laura, 47, started looking for alternatives and found a policy through Anthem Blue Cross for $305 per month. "I wasn't surprised that I could find less-expensive insurance, although I was not expecting to save as much as we are," she says.

One reason the Bests' health insurance was so expensive was that Shaun, 52, has high blood pressure. But each insurer looks at health conditions differently. "One insurer may charge a lot for a particular condition, while another might offer the same person the lowest possible rate," says Scott Leavitt, a health insurance agent in Boise, Idaho, who generally gathers medical records and gets prices from at least three insurers for clients with medical conditions (find a local agent at the National Association of Health Underwriters' Web site).

The Bests also saved money by making some trade-offs. They wanted insurance their doctor accepted, but they didn't mind a $2,500 deductible because they plan to use HealthyCheck centers, which charge just $25 for basic visits and screenings. (Also see "Need health care? Try Planned Parenthood.") They opted not to pay for prescription coverage because Shaun's medications are currently available at many pharmacies for $3 and $5. And they gave the insurer extra medical records showing that Shaun's high blood pressure has been well controlled for 30 years with a very low dosage of medication. The search paid off, saving them more than $7,000 per year in health insurance premiums.

Several insurers recently introduced new policies targeted specifically at people in their 50s and early 60s. Aetna's AARP policies are easy to shop for online and lessen restrictions for medical conditions common to that age group, such as hypertension, high cholesterol and weight gain.

If private insurers reject you, 33 states offer coverage through high-risk pools. Other states may have at least one insurer that accepts anyone, or they may require insurers to provide continuation policies for people with health conditions after they exhaust COBRA. See "A survival guide for the uninsured" for help.

Continued: If you're a recent grad

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