Reader Friday: Health Insurance and the Self-Employed Writer

Many in the thriller writing community are aware that writer Tom Piccirilli is battling brain cancer. Surgery to remove a tennis ball-sized tumor was successful, and now a long recovery and ongoing fight are in store. So are medical costs. Which brings up the issue of health insurance for the self-employed writer. Thanks to frequent commenter Terri Lynn Coop for suggesting this as a Reader Friday topic. Let’s start a discussion on strategies for writers who must find their own health insurance coverage. 

[NOTE: This is not a political forum, so let’s keep partisan politics out of it. This is about what to do right now with options currently available.]

Meanwhile, if you’d like to help Tom out, here are some options

13 thoughts on “Reader Friday: Health Insurance and the Self-Employed Writer

  1. That’s a tough one. For a lot of fledgling writers such as myself, giving up the salary of the “day job” isn’t as daunting as giving up the insurance.

    I’ll contribute to the Indiegogo fund, and my thoughts are with Tom and his family.

  2. I lost my United Health Care policy when my husband went on Medicare (won’t bother with the makes me angry) and had to scramble to get new insurance as self-employed writer. Tried Author’s Guild but man, its expensive. In near panic, found an insurance agent who specializes in this and he got me decent policy with Aetna but I am paying dearly. I wish I had some good advice here but my experience was scary and negative. I’m trying to hang on for Medicare to kick in.

  3. This is not a happy subject for most self-employed writers. You either try for coverage under a spouse’s policy (expensive), buy private insurance (very expensive), or go without. And like Kris says, if you’re old enough, Medicare eventually kicks in. Another reason to hang on to your day job as long as you can. Once you’re on your own, one extended medical crisis can crush you.

    Thanks, Jim, for mentioning Tom and his battle with cancer. He’s not only a great writer, he’s a really nice guy. So everyone, give what you can.

  4. The only ‘best’ option for a writer, sadly, is to have a spouse who has health insurance. Individual policies are available, but the cost is prohibitive. Unless you work for a large company, health insurance costs a fortune, and the insurers deny everything they can get away with. I recently got an estimate for a routine test, and the estimate was $16,000.00! My portion was going to be ~$4,000, although not all of that out of pocket. I cancelled the test. And this was with relatively ‘good’ insurance with Anthem-Blue Cross. Plus we just got a letter stating that they’re removing UCLA from their list of covered hospitals. UCLA is where my doctors are; so I’ll be switching insurance carriers next year. We can do this because my husband owns his own company–but if you work for someone else, you’re stuck with the carrier they choose.

    At least now they can’t reject you for having a pre-existing condition, although that may not last.

  5. This is a topic that brings out my inner safety engineer. This is about risk-management. In my overly-ordered view of the world, writing careers, like pretty buildings, have to be built upon strong foundations. I cringe every time I hear about people who walk away from a bill-paying career to pursue a full-time writing without a backstop.

    It’s sad but true that a million-dollar book deal at age 35 is not enough (in my view) to justify the risk of full-time writing. In any creative field, you never know if the next project will sell. Health insurance alone will run a family of four something on the order of $15,000 per year. In my view, that’s not optional money. It’s a need-to-pay.

    Do the math: On $1 million, $150,000 comes off the top for your agent. Of the remaining $850K, easily $300K will go to federal, state and local taxes. That leaves $550,000. Over the next thirty years till Medicare, $450,000 will go to healthcare insurance alone. The real cash value of that $1 million advance, then, is about $100,000. Granted, this is a worst-case, static analysis, but bear with me.

    By contrast, if that $850,000 is invested, assuming a moderate average return of 5%, that money will convert to $2.25 million over twenty years–in my mind, still not enough to sustain me and my family for a forty-year retirement, but it’s getting close. Meanwhile, the dreaded day job has paid the bills and provided for other essentials (like health insurance, 401K contributions, additional life experiences, etc.). Speaking of the 401K, a $10,000 annual contribution over 20 years with a 5% return will deliver another $374,000 at age 55, bringing the cash value of patience to $2.6 million.

    The fact of the matter is that million-dollar advances are rare, and million-dollar earnings from writing are rarer. Ensconced as I am in my Big Boy job, all of the proceeds of my writing go straight to the retirement fund. I work fourteen, fifteen hours a day at two full-time jobs, enduring the exhaustion and frustration in anticipation of a financially stress-free retirement, which will in fact be a reduction down to a single full-time job.

    Walking away from a Big Boy job is an important decision. But it’s not about artistry or an easier life style. It’s really about math.

    John Gilstrap

  6. For the first fifteen years of my professional life I almost never had insurance, being self-employed most of the time. I calculated that paying $500 per month or more for private insurance ended up being a lot more than I paid out of pocket every year to go to the doc. And we only went for emergencies anyway, which we almost never had. I had VA coverage for myself, but didn’t know I could get all my care there.

    In 2003 I, after getting a government job with insurance, I realized the value of such when my appendix decided to jump ship. From 2008-present I tore my shoulder in a skiing accident, had foot surgery on a torn ligament, my oldest son had a cancer scare, my two younger sons both broke bones with their rough-housing and my wife had an infection that nearly killed her. Without insurance those would’ve cost up upwards of 100k in a four year period.

    All of a sudden the value of insurance became a very clear motivation for keeping the day job as long as possible or until my assorted business ventures in writing and narrating pay enough to cover those unexpected expenses.

    The only option I can think if I were to give up the day job would be one of those contribution co-op deals I know many friends in ministry use to cover major medical emergencies. And just try to stay healthy as much as possible.

    Praying to Tom, and giving to the cause as well.

  7. Health insurance is yet one more reason I’ll be stuck with my day job till I die. Best hope is to find small spaces to write in between. Some people thrive on chaos and the uncertainty of self-employment. I’m not one of them.

    I might view it differently if I was 25. But that was a loooong time ago. ๐Ÿ˜Ž

    BK Jackson

  8. I discussed this issue last night over dinner with a hospital administrator. She suggested that writers form a group in order to get a group policy. We’d need a minimum of 50. Sounded interesting, but I guess that’s what Author’s Guild offers. But as Kris mentioned, that’s expensive. I did note that this hospital administrator said, “Everyone I know works for a corporation or company with insurance. Maybe we’re blind to the issue, but…”

    Yeah, you could say they’re blind.

  9. Sort of late to the discussion, but I only have a ditto to add. That is to say, I’m a full-time freelance writer, editor and novelist, but I wouldn’t be if my wife didn’t have good healthcare insurance through her job.

  10. Thank you so much for posting this and thanks to everyone who has contributed. The Piccirillis found out today that Tom was denied for Medicaid, so every dollar counts.

    I’m late responding because I was at a conference getting chomped by agents. Well worth the trip.

    I have been without insurance since 1995, except for a 8-month stint on a temp job that I took strictly for benefits so I could get needed surgery on my hand. Of all the professions, lawyers are one of the most under-insured because so many are self-employed.

    I had a hard head-on collision with the real world when my (now ex) husband was critically injured in a freak accident. Through sheer will power and an excellent social worker, I bulled through the paperwork and was able to get him on Medicaid. The cost? Everything we had. My retirement savings . . . poof. But it had to be done.

    I also got to see his medical bills, almost $1 million in the first week. You laugh because you have no choice. But I kept on pushing and got his disability approved as well so he has the fundamentals. I also avoided bankruptcy through sheer audacity.

    I’m currently applying for a big girl job right now just because I am so damn tired of worrying.

    I’ve recommended to Tom’s wife that she see a lawyer. However, in the mean time, thanks again to everyone who is helping out.


  11. As a small business owner and writer, insurance is a BIG issue for myself and my employees. Our tiny group was not attractive to insurers. So, we joined the metro Chamber in our area and participate in their group BCBS plan. Sure, $1250 a month is expensive for my husband and I, but we wouldn’t do without it. We have great coverage and more than save the $350 a year Chamber dues.

  12. One of my great frustrations with the MWA is that despite having an enormous membership, the only health care available through them is actually more expensive than a single plan. IMHO, we could spend less money on mailing everyone Edgars programs, and focus on really making it an organization that provides services to writers–healthcare being first and foremost.
    And oh yeah- consider voting for the guy who actually offers universal healthcare as part of his platform. It’s past due.

Comments are closed.