topic Re: Private Health Insurance in Wellness

Private Health Insurance

NeNe1010 — Wed, 17 Aug 2016 13:58:01 GMT

My daughter recently decided that she would like to start working part time for maybe 2 years (she is a Nurse) so she can spend more time with her 4 year old and 7 month old sons. She is not elligible for health insurance from her employer if she goes part time and her husband works for a small business owned by his parents and has no health insurance benefits. She is trying to look for options for health insurance that dont cost a fortune. So far they found one which is $590.00 a month, covers catastropic events only and they can cancel them at any time. It is really sad when you cant afford to stay home with your young children because of health insurance worries. Does anyone here have private health insurance advoce or any suggestions for them? Thanks in advance.

Re: Private Health Insurance

Anonymous — Wed, 17 Aug 2016 14:04:59 GMT

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Re: Private Health Insurance

NickNack — Wed, 17 Aug 2016 14:06:08 GMT

If she waits until November 1 she could get Obamacare from HealthCare dot gov. The premiums would be high, although she might be able to get help with that depending on their income, but they couldn't cancel her. She might be able to get it now since she loses health insurance through her employer due to going part-time. She would have to call them and talk with them about it.

Re: Private Health Insurance

ALRATIBA — Wed, 17 Aug 2016 14:06:18 GMT

Has she tried the ACA exchanges for her state? The link is to an info site.

Re: Private Health Insurance

Abrowneyegirl — Wed, 17 Aug 2016 14:13:02 GMT

This is a TOUGH situation! The only people who benefit from ObamaCare are the very poor. Try to earn some money AND want health insurance you pay dearly.

When she shops she should compare the price with her part time income vs her not working at all. It may not pay for her to work! Sad.

Re: Private Health Insurance

sueeich — Wed, 17 Aug 2016 14:16:15 GMT

In all seriousness, I would personally stay far away from the state exchanges. I think several of them have folded and yet another insurance company has said they are going to pull out of the exchanges because they can't make any money. My twins had their well check up a couple of months ago and I was telling the office person that was checking me out that my health insurance (through a private employer) hadn't yet paid for anything this year because I still haven't met my deductible ($4,000/family for the year). She told me that most of their clients at this pediatrician pay for all their medical expenses out of pocket because their deductibles are more like $10,000/year because they can only afford to purchase the health plans with high deductibles. I have been hearing about cost-sharing health insurance which sounds interesting. Maybe something to check into?

Re: Private Health Insurance

bonnielu — Wed, 17 Aug 2016 14:18:40 GMT

Bad situation all around. No one should have to choose between caring for children and working full time for health care.

Even as old as I am, I carried the health insurance for the family.. hubby was in a private business with outlandish health insurance costs. I worked until retirement and still am the carrier. Had I not done that, we would be in the same situation. Our daughters are doing fine, it really did not impact them as much since my summers were off... school teacher benefit I guess.

Not a fan of Obamacare because I know one of my daughters is struggling with it. She cannot get needed medicine at fair costs and she needs it to keep alive, literally.

Re: Private Health Insurance

NeNe1010 — Wed, 17 Aug 2016 14:32:53 GMT

Thanks for all the suggestions. I will pass this info along to her and hopefully we will figure something out.

Re: Private Health Insurance

SilleeMee — Wed, 17 Aug 2016 14:53:45 GMT

I am 61, live alone and retired due to disability. I am not Medicare-qualified so I was forced into buying private health insurance. My income is not substantial enough to pay for it, however, and I applied for financial assistance (tax credit) available through my state health insurance exchange which is the Obamacare institution for health insurance here. Most states have some kind of option for getting coverage and if not go to Healthcare dot gov for more info.

These health insurance exchanges list insurance agents that can assist getting coverage and it's free. I can't stress enough how important this part is. Get an agent!

Health insurance plans are ranked according to type of coverage and deductibles. These plans go by the name Bronze, Silver, Gold and Platinum. Each state has their own set of companies that provide these plans.

Before deciding on a plan, make sure you have shopped around beforehand.

Re: Private Health Insurance

Retiredpsych — Wed, 17 Aug 2016 15:00:16 GMT

Contact and agent for UnitedHealthCare. They are the largest in the country, along with BlueCross/Shield. They pulled out of ObamaCare because they were not getting paid. They advertise that they have affordable plans for everyone. I have a UHC/Medicare Advantage Plan and it is great...it is an HMO. If you can do HMO it is much cheaper. A PPO will be very pricey.

Re: Private Health Insurance

carlycat — Wed, 17 Aug 2016 15:59:34 GMT

I am 59, was laid off, and now work part time so no health insurance. I got mine through the ACA. I receive a tax credit so my plan is affordable. If it weren't for the ACA, I don't know what I would do. I don't understand why people are so violently opposed to it. It provides health care for everyone, and if your income is lower, it lowers the cost of health care so it's more affordable. Maybe people do not understand that when you get coverage through your employer, the employer is paying part of the cost and that's why it's "lower."

At any rate, do not be afraid to get insurance through the exchange. It is exactly the same insurance as private, simply available to anyone. And if you have a lower income, you may be available for a tax credit (which means your premium will be lower.) If your daughter is working part time now, she can sign up now, that is a qualifying event. If her husband currently has no benefits they can both sign up now.

Good luck.

Re: Private Health Insurance

3suwm5 — Wed, 17 Aug 2016 16:01:27 GMT

I think you have gotten some really good advise here.

When we carried our own private health insurance a few years ago, it was beyond pricey and they had reasons to keep from paying most everything. Our premiums were ridiculous and our deductibles were outrageous.

I feel for your daughter, I hope she can find a reasonable solution. It may be staying home all together, or working one weekend a month; just to keep up her clinical experience. MO

Re: Private Health Insurance

Tinkrbl44 — Wed, 17 Aug 2016 16:32:22 GMT

@NeNe1010 wrote:
My daughter recently decided that she would like to start working part time for maybe 2 years (she is a Nurse) so she can spend more time with her 4 year old and 7 month old sons. She is not elligible for health insurance from her employer if she goes part time and her husband works for a small business owned by his parents and has no health insurance benefits. She is trying to look for options for health insurance that dont cost a fortune. So far they found one which is $590.00 a month, covers catastropic events only and they can cancel them at any time. It is really sad when you cant afford to stay home with your young children because of health insurance worries. Does anyone here have private health insurance advoce or any suggestions for them? Thanks in advance.

@NeNe1010

A couple things come to mind ..... first, any chance her husband's parents will be offering health insurance options any time soon? If not, any chance they will give employees a "health insurance allowance" to help with the costs? I've seen many small businesses do this when they can't afford the whole tab.

Also, You don't say how much she is paying with her employer now, but perhaps, if she can't find anything they can afford, she just reduces her hours to 30 a week instead of 40 hours a week? I know it's not the perfect solution, but the loss of her full time income PLUS the cost of health insurance for four is going to be a big financial hit.

I hope this gets sorted out!

Re: Private Health Insurance

Tinkrbl44 — Thu, 18 Aug 2016 00:51:32 GMT

@Abrowneyegirl wrote:
This is a TOUGH situation! The only people who benefit from ObamaCare are the very poor. Try to earn some money AND want health insurance you pay dearly.
When she shops she should compare the price with her part time income vs her not working at all. It may not pay for her to work! Sad.

@Abrowneyegirl

That's not true. In my state, I was paying $700+ a month and with the ACA my coverage it dropped to $369 a month, and I am not "poor".

Re: Private Health Insurance

ccassaday — Thu, 18 Aug 2016 01:05:26 GMT

I had Obamacare for two years with United. It saved me from huge premiums until I became elgible for Medicare two years after my disability. Unless your poor it won't be any cheaper then finding your own plan. United is pulling out after this year. But I will say my converse was excellent with it. I had a PPO. When looking for private insurance a HMO will be cheaper but you can only go to certain doctors and hospitals. Any out of network will not be covered cat all. With a PPo you just have s higher cost to go out of network. It's ridiculous a mother has to work for healthcare and can't stay home with her child.

Re: Private Health Insurance

vickie25 — Thu, 18 Aug 2016 03:43:28 GMT

After 30 years with the same company, I was laid off in 2015. I was fortunate to be in a profession that can find contract work so that is what I am doing. Because I didn't want the hassle to find new insurance, I took my old company's COBRA plan. That expires end of this month.

I went and looked on the exchange. I think because it is not an active enrollment period, there was literally like 1 plan out there - Molina Advantage Plan. High deductible and high cost. Almost cost as much as my COBRA. But COBRA covers dental and vision which, of course, the ACA plans do not. I stressed out for 2 weeks about what I was going to do. I checked with my contracting company and their health insurance plan was worse than the Molina one.

Luckily, I found out that when I was laid off, my company "retired" me. I was eligible to participate in their retiree plans. The cheapest one, and this is coverage for just myself, is $537/month, with a $5500 deductible and $7000 max out of pocket. All of the plans are with United Health Care. It will pay for a yearly physical, well woman exam, and cancer screenings. Any other medical services will be paid 80% once I meet the $5500 deductible.

I am only locked into this plan through end of year. Starting in November, I can see what the plans/prices will be for the retiree plans in 2017 and look at the ACA plans. A friend has given me a name of an agent he worked with when he was contracting and needed to purchase insurance. He's telling me I can find something cheaper during open enrollment. We shall see.

I am 7 years away from Medicare. I really need to find another full time job just for the health insurance. Actually I have more dental needs than health needs at this time so I am out of luck. I am fortunate to not be taking any prescription meds or have any health issues presently.

Like others have said, before your daughter decides to go part time, what till the open enrollment in November and see what the cost would be. Then she can make an informed decision. I hope she is able to spend more time with her children.

Re: Private Health Insurance

Tinkrbl44 — Thu, 18 Aug 2016 15:16:44 GMT

@ccassaday wrote:
I had Obamacare for two years with United. It saved me from huge premiums until I became elgible for Medicare two years after my disability. Unless your poor it won't be any cheaper then finding your own plan. United is pulling out after this year. But I will say my converse was excellent with it. I had a PPO. When looking for private insurance a HMO will be cheaper but you can only go to certain doctors and hospitals. Any out of network will not be covered cat all. With a PPo you just have s higher cost to go out of network. It's ridiculous a mother has to work for healthcare and can't stay home with her child.

@ccassaday

We know nothing about their income and expenses. One could also argue that if you can't afford children, don't have them.

One thing I didn't see here ..... if her job is so solid with such good benefits, maybe she should keep working and her husband should stay at home with the kids! His benefit package is non-existent. JMO

Re: Private Health Insurance

151949 — Thu, 18 Aug 2016 16:24:56 GMT

I think a woman who is intelligent enough to be an RN is intelligent enough to figure out the ACA and find herself some coverage. Previous to the ACA I knew many nurses who found it was cheaper to just quit working and get CHIP for their kids than go part time.

Re: Private Health Insurance

3suwm5 — Thu, 18 Aug 2016 16:54:53 GMT

When my husband retired from a government contractor, the 'retiree' plan was ever more pricey than a private plan. We went from $240 a month for 4 people to $1,900 a month, with HUGE deductibles. Retiree plan was certainly not an option for us. We knew the employee plan was not usual, but that increase was more than ridiculous.

She just needs to weigh her options, after what seems to be a quite involved research 'project'.

Re: Private Health Insurance

Toppers — Fri, 19 Aug 2016 10:58:50 GMT

@carlycat wrote:
I am 59, was laid off, and now work part time so no health insurance. I got mine through the ACA. I receive a tax credit so my plan is affordable. If it weren't for the ACA, I don't know what I would do. I don't understand why people are so violently opposed to it. It provides health care for everyone, and if your income is lower, it lowers the cost of health care so it's more affordable. Maybe people do not understand that when you get coverage through your employer, the employer is paying part of the cost and that's why it's "lower."
At any rate, do not be afraid to get insurance through the exchange. It is exactly the same insurance as private, simply available to anyone. And if you have a lower income, you may be available for a tax credit (which means your premium will be lower.) If your daughter is working part time now, she can sign up now, that is a qualifying event. If her husband currently has no benefits they can both sign up now.
Good luck.

There are people for whom it is still not affordable. That may be why people are still opposed to it.

If someone doesn't qualify for Medicaid, they may make too much money to qualify for Medicaid. However, that doesn't mean that they still aren't low income, as to where they still aren't struggling to make ends meet for their families, and where these plans are still too expensive for them.

They may not be able to afford the cost of the deductibles and/or co-pays, or monthly premiums of these plans.

With some of the plans someone has to meet a deductible with prescription coverage before they are covered.

It just may be that these plans are still too expensive for some people when all of the associated fees and costs are factored in with them.

Even after a tax credit is applied, the plans may still not be affordable for them.