This will be a self-funded business with an extremely long runway (in a good and contractually stable living situation with my childhood/teenage/adult best friend, paying virtually nothing in rent (percentage of net income up to a limit)) - this is a stable situation with extremely synchronized understanding of responsibilities of each party. To be clear, I am living on less than $500/mo, and my investments provide more than this, with rock-solid monthly cash distributions around $1100/mo.
My question is about insurance. Given my operating income of ~$600/mo after expenses (very little taxation at this income level), I am concerned about the cost of health coverage and am wondering if any other founders / small business owners have dealt with similar situations.
I have found healthcare.gov plans with ~$250-$300/mo premiums. I'm young and healthy and have a great doctor who refills my single generic prescription visiting her just once a year. Even w/o insurance, my annual costs are less than the monthly premiums of what healthcare.gov offers. I really just want catastrophic coverage where I pay ideally $XX/mo, have an $XX,XXX annual out of pocket max & deductible, but that doesn't appear to be an option in my state's healthcare.gov program.
Has anyone found a solution for this? Are there umbrella insurance policies that cover some crazy rare medical issues with six digit bills? Am I going to be eligible for Medicaid with considerable assets but extremely little income (until I start having revenue rolling in) in an HCOL area? I know some tax credits are available for the $250-$300/mo healthcare.gov plans for low income folks, but that'll come as a tax credit once a year and thus I'll still be cutting my operating income in half, if I'm even eligible for it (again, six figures worth of assets).
What have fellow HN'ers in similar situations done, and what would HN'ers in such a situation do, barring "stay at the comfy big tech job"?
Regarding:
> I really just want catastrophic coverage where I pay ideally $XX/mo, have an $XX,XXX annual out of pocket max & deductible, but that doesn't appear to be an option in my state's healthcare.gov program.
… in most states, the marketplace includes plans with $5k-$10k deductibles and out-of-pocket annual max of about 2x that. For a non-smoker under 40, the premium will probably be $250-$400 (depends on age, area cost of living).
That's the viable version of the plan you described.
There's 2 main reasons that no plans offer something like a $25,000 deductible and $50,000 out-of-pocket max:
1. State insurance commissioners and the ACA require certain minimum coverage. For example, the ACA requires https://www.insurance.wa.gov/what-health-insurance-plans-mus... and Washington State requires https://www.insurance.wa.gov/benefits-health-plans-must-cove.... Some of these require certain paid coverage levels regardless of deductible; for example, the ACA requires most preventative care be covered without out-of-pocket costs.
2. Increasing the deductible and out of pocket max significantly (say, $25k/$50k instead of $6k/$12k) doesn't decrease the insurer's total costs all that much. For plans with $5k+ deductibles and $10k+ limits, the insurer's major cost is six-figure treatments, and the insurer will be responsible for those either way. Just to use hypothetical numbers, raising the plan limits 4x might decrease the premium by 20%. Most of the cost is either item #1 above or really expensive treatments, not care that costs $6k-$25k.