Health insurance changes

SeñorAmor

Greetings, fellow forumers!

I just received notice from my employer that my health insurance premiums are going to increase (27%, I believe, is what my boss told me). My bosses told me this is due to the ACA (like the good Republicans they are), and while that may be true, I'm hoping I can use the ACA to my advantage and find cheaper, better insurance. Unfortunately, I'm not really sure how to go about this, and was hoping one of you smarty-pants could assist.

I'm a 35 year old male from WI and I'm currently covering myself, my wife (34) and my two children (5 and 3). I currently have no co-pay on any doctor's visit, but have a $6000 out of pocket deductable and get basic things like flu shots for free. I do not have any dental coverage as my provider does not offer it. I can get it through Aflac, but at this point, it's actually cheaper to pay out of pocket than it is to have insurance (that may change when my kids are older and need things like braces).

The document my boss gave me said my insurance will be approximately $250 per check (26 checks / year). I'm not sure if that's good or bad for what I have, and would gladly entertain other offers, if I knew how to find them properly. I've checked out healthcare.gov and everything there seems obscenely expensive, but it's possible I'm looking at the wrong stuff.

Help me, Penny Arcade. You're my (and my ridiculously adorable family's) only hope!

Enc

$541.67 a month for a family of four seems pretty decent to me, though your deductible seems really high for that.

Djeet

My employer gave about 4 (all ACA) options (and we have a tiny US office). So I had a range of plan options depending on if I didn't expect chronic office visits, to high deductible coverage, to little out of pocket for office visits or outpatient procedures (all with commensurate differences in premiums). You could suggest that they investigate that to give their employees more choice. They might need to do a little homework, but I don't believe offering choice is going to cost them much.

zepherin

Start here and look up the Wisconsin, then fill out information.
https://www.healthcare.gov/get-coverage/

shadowane

Don't you not get subsidies from the ACA public market if your employer offers insurance even if you decline it?

SeñorAmor

Enc wrote: »

$541.67 a month for a family of four seems pretty decent to me, though your deductible seems really high for that.

I've had a $6000 deductible for several years now and I haven't come anywhere close to it. I'm paying my monthly premiums and all doctor's visits. I feel like I'm getting raked over the coals on this arrangement.

Djeet

If you decline your employer-sponsored health insurance you will not qualify for a subsidy unless the plan is either "unaffordable" (costs more than 9.5% of household income) or "inadequate" (has an actuarial value less than 60%).

It's possible your coverage qualifies as one of those, but you'd have to do some legwork to determine if you qualify for a subsidy if you declined the employer-sponsored plan. I think that may be tough to do unless you know the cost-sharing of the plan (how much of your premiums your employer is paying).

localh77

I can't really help with recommending a good plan, but whichever plan you go with, I would suggest looking into opening an HSA if you don't already have one. It's pretty easy; as long as your health plan qualifies as "high deductible", and presumably it will, you can deduct all of your contributions, and then use them tax-free for expenses (copays, prescriptions, etc.). That's kind of the point of HSAs, I think. You have a high deductible plan in order to keep your premiums down, but then you also have an HSA so that you don't have to pay tax on your medical expenses. Anyway, just a thought.

bowen

$6000 is definitely high deductible.

Out of pocket max for a health insurance that high is probably in the 5 digit realm too. Also, you should look into seeing if your state has a form of child medicaid(child health plus in NYS for instance), it might be cheaper than your health insurance and you might qualify for it.

https://www.health.ny.gov/health_care/child_health_plus/eligibility_and_cost.htm

Looking at that chart, you'd have to be pulling in $4500 a month to start paying some premiums. Even then, those premiums are super fucking affordable. Get your kids on medicaid if at all possible.

bowen

https://www.dhs.wisconsin.gov/health-care-coverage/health-care-coverage/medicaid/badgercare-plus/how-apply

Looks like it's called badgercare in your state. Give it a shot, I assume WI is probably similar to NYS!

Jasconius

for a family that's not a terrible deductible

don't forget that the primary function of the health insurance in our dumb system is negotiated rates. if you feel that the prices are fair for service then there's no reason to switch. The price you will pay for a lower deductible will be severe.

Frankly a high deductible no-copay plan is a pretty sweet deal especially with kids

also $500 per month is also fine for a family that size

tinwhiskers

bowen wrote: »

$6000 is definitely high deductible.

Out of pocket max for a health insurance that high is probably in the 5 digit realm too. Also, you should look into seeing if your state has a form of child medicaid(child health plus in NYS for instance), it might be cheaper than your health insurance and you might qualify for it.

https://www.health.ny.gov/health_care/child_health_plus/eligibility_and_cost.htm

Looking at that chart, you'd have to be pulling in $4500 a month to start paying some premiums. Even then, those premiums are super fucking affordable. Get your kids on medicaid if at all possible.

HAHAHA good luck with that in Wisconsin.

This doesn't seem to be an absurd plan/rate but IDK really what is good anymore.

Also OP needs to have an HSA set up and be funding it if he is on a HD plan. Those limits are a lot less bad if you can save for them, and pay them tax free.

bowen

Yeah WI is really... not very forthcoming with the limitations to their plans.

Guess I'm glad I live in NY!

SeñorAmor

Djeet wrote: »

If you decline your employer-sponsored health insurance you will not qualify for a subsidy unless the plan is either "unaffordable" (costs more than 9.5% of household income) or "inadequate" (has an actuarial value less than 60%).

It's possible your coverage qualifies as one of those, but you'd have to do some legwork to determine if you qualify for a subsidy if you declined the employer-sponsored plan. I think that may be tough to do unless you know the cost-sharing of the plan (how much of your premiums your employer is paying).

The document he gave me said 50%. I presume that to be true. I can't imagine how much trouble he'd get in if he were lying about it.

SeñorAmor

localh77 wrote: »

I can't really help with recommending a good plan, but whichever plan you go with, I would suggest looking into opening an HSA if you don't already have one. It's pretty easy; as long as your health plan qualifies as "high deductible", and presumably it will, you can deduct all of your contributions, and then use them tax-free for expenses (copays, prescriptions, etc.). That's kind of the point of HSAs, I think. You have a high deductible plan in order to keep your premiums down, but then you also have an HSA so that you don't have to pay tax on your medical expenses. Anyway, just a thought.

I had an HSA. My employer contributed $100 each check to it. It was discontinued, however, right before I got the notice my insurance was going up.