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by ljoshua 1817 days ago
This really isn't as true as it's made out to be. I've done it, and with four dependents in tow as well.

If you currently work for a big company (or really any company with >50 employees if I recall) you can qualify to take COBRA when you leave. Doing so is expensive, sure, but it's really usually about the same price as private insurance but much better (because it's a group plan). You can elect COBRA for up to 18 months, or 24 in some cases.

When COBRA runs out and you aren't yet in a position where you can have the organization you've founded pay for it, you can either look at joining a PEO or you can simply buy private insurance. Yep, it's definitely not great, but it is coverage. Additionally, if you are doing your own thing, look into setting up an HRA for yourself/your company--it lets the company pay for your medical costs without even when you're buying private insurance.

Not sure how to pay for it out of the gate when you might be pre-revenue for a while? You still have a couple of options. First, saving specifically for this use case makes a lot of sense. Even better, if you are currently in an HSA-compatible plan at work, max out the account for the year because you can use HSA savings to pay for premiums. Or if you have a spouse or SO and can hop on their plan for a while, good call too.

In general, and speaking from the position of someone who has spent far more time than I wish to admit building models and forecasting health expenses for when I was on private insurance and doing my own thing, it can be done. The freedom was definitely worth the price.

2 comments

This is really helpful info. I've been looking at this stuff a lot and I learned these things from you:

- COBRA and private health insurance are comparable in cost (I always assumed it was way more expensive)

- HSAs can be used to pay premiums

These are important pieces of information for figuring this out for me. I don't have four dependents, but I have two and don't have the option of jumping to a spouse's plan, so thanks for the additional context.

Glad to be helpful. As noted in the other comment and with all things, YMMV, but there's definitely reasonable options out there.
> you can use HSA savings to pay for premiums.

This is not true, as far as I know. I'd consult a CPA for an authoritative answer, but from https://www.healthcare.gov/glossary/health-savings-account-h...

> HSA funds generally may not be used to pay premiums.

Good to note, this may have changed then. It was okay last time I did it.

HRAs on the other hand are a good vehicle for this.

EDIT: Ah, there is indeed an exception for continuation of coverage under COBRA which makes it acceptable to do so: https://dpath.com/hsa-and-cobra/

Awesome, thanks for digging that up! My bad.