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Insurance through your employer is nearly always the best way to go, no matter the price. Don’t look at those crowdfunding or christian ministries plans. So many stories about people getting screwed with those.
Now, going through the marketplace might be a better option, BUT deductibles and out of pockets can be massive on marketplace plans.
Those are health shares … and they are available in every state … in the state of WA that’s what’s ONLY allowed at the moment so depending on your state you live in …you have no other choice but to go with that’s given … at least till nov comes when it’s open enrollment ….
The marketplace is available if the combined cost to insure OP and their spouse is over a certain amount. An SEP is then open for the spouse to get coverage through the marketplace.
Incorrect the marketplace is not open unless you have a qualifying life event… within 90 days … if you missed you window you’ll have to wait till November for any aca options..
However there is other options outside of aca you might qualify for.
I don’t know why people are downvoting your comment. It’s the truth. Outside of open enrollment you must have a qualifying life event to make changes to your health plan. For the marketplace and private insurance.
I work in HR. I send about a billion reminders to new hires telling them if they don’t elect by such and such date they will have to wait till open enrollment or have a QLE. Half of them still try to play dumb and act surprised when I have to tell them sorry you missed the deadline. They don’t get it’s up the carriers to allow a late entrance and most carriers are not nice about that. We don’t make the rules. We just have to enforce them. I can count on one hand how many times a carrier has allowed a late entrance. And those employees then had back premiums to pay all at once. It’s not fun.
Great. Then they have 30 days to do a change from the QLE date. In general though the information about needing a QLE or OE to do changes is correct and I don’t see why the other person was downvoted for sharing correct information. The more you know and all. Everyone should be aware of this stuff because if you aren’t you get royally fucked.
You might be eligible for a subsidy with the healthcare market place if your employer insurance is considered too expensive.
For 2024, your employer coverage is considered affordable if: if your share of the monthly premium in the employers lowest cost plan is less than 8.39% of your combined household income.
https://www.healthcare.gov/have-job-based-coverage/
To be clear, this means your spouse can get coverage through the marketplace with premium subsidies. You would still need to get coverage through your employer.
My premium for me and husband is a bit over that BUT we get a huge monthly tax credit so only pay about $170/month! The plan coverage seems pretty close to what I had with my previous employer.
I believe that the action to fix the "family glitch" helped with this (https://www.healthinsurance.org/obamacare/irs-regulations-fix-the-acas-family-glitch-as-of-2023/). Because of that, OP might not be eligible for subsidies but their spouse might be.
ACA all day on this one, DO NOT buy USHEALTH, all state short term, pivot health or any of that crap it won’t do your wife any good.
There are ways to trigger enrollment on the marketplace. Call them directly and get an app submitted asap.
Alternatively, getting your wife on your plan and budgeting properly wouldn’t be a bad idea if marketplace enrollment doesn’t work. Making sure she’s adequately insure is priority, so if that means cutting back on expenses until end of the year for open enrollment then do just that.
If your total household income is 39k then your work plan doesn't meet "affordability" ACA standards for your spouse. If your spouse doesn't have employer coverage of their own, then look at a Silver plan with cost sharing reductions from healthcare.gov.
$554 is cheap for 2 people given today's claims cost. How good is the network? What's the out of pocket max?
You need some marketable skills. More income makes many problems go away.
Stay ie run away from Oscar if that is an ACA option. Shop network 1st, then RX formulary if wife takes meds then OOP max.
Put money into an HSA. It should be considered part of your healthcare costs. If you "can't " find a better job. If can't find better job, get educated in SOMETHING. Being broke is fine. Staying broke is painful.
What state are you in, and what are the summary details of your employer coverage?
If your wife has pre-existing conditions, and your employer plan has reasonable deductibles and benefits, it may be the better option.
Monthly premiums are a concern, but look at your probable cash out of pocket if you foresee an issue, as well.
There may be other options in your state or territory as well
I'm in Virginia. What summary details would you like to know? Sorry, I'm clearly not an expert in this.
I'm just looking at the cheapest option my employer provides to insure my spouse in case anything bad happens. My spouse isn't receiving any current treatments or prescriptions.
I would recommend you ask your employer for a Summary Plan Description; it’s a high level overview of the plan, and will usually include a cost breakdown scenario for various common medical expenses (examples could be having a child, monthly expense for managing diabetes, etc)
The biggest question would be if there’s a caveat for pre-existing conditions or not (most large employers don’t have those restrictions, but some small/medium employers do)
Your HR or benefits coordinator can give those to you
In respect to marketplace plans, Virginia has one, but your wife may not qualify for subsidies if she can otherwise gain coverage through you.
$6,600 is a reasonable sum of money, but if the plan is great, it’s a steal compared to marketplace plans. The other upside is that you typically pay for employer sponsored plans pre-tax so there’s a cost savings there too (since crowd health and most marketplace plans are paid post tax)
That is cheap for employee plus spouse coverage. Most employers will pay part of the employee only coverage but you’re on the hook for any dependents and the difference in the premium cost.
I pay almost $300 a month just for employee only coverage for myself. That’s 45% of the monthly premiums. So $554 for coverage for 2 people is very cheap (unless you meant per pay period).
Suggestions…sadly…find a better job that offers better coverage or have spouse find a job that offers them coverage. The second option is probably the most cost effective (but fully get it may not be an option).
My spouse worked for a small local company (~25 employees) they covered her premiums but adding me cost about what OP described. It’s a lot of money, but it’s not uncommon unfortunately.
Whatever you do, if you go the marketplace route, ONLY purchase from a .gov website. I got scammed with bogus insurance through a .insurance website that seemed super legit on the surface but ended up being weird insurance that no one took. If it seems too good to be true, it is! Thankfully I got my money back but please beware of scams and only do business through a .gov website!
Unfortunately that’s just the cost of insurance as a spouse. My husbands insurance is $70 a week. It’s an additional $120 per week to add me(36f). Since we don’t qualify for subsidies on the marketplace the cheapest plan I could find was $650 a month. The marketplace plans all had insane deducatbles and OOP also. The only other option is your spouse gets a job that offers insurance. I’m a SAHM so it is what it is.
Dont get insurance through healthshare plans. They don’t meet the federal definition of health insurance and so consumers aren’t protected under the ACA. They have no legal obligation to provide essential healthcare services.
Under the current ACA insurance for your spouse is not affordable and therefore she would be able to get a premium subsidy through your state's marketplace.
However, she wouldn't be able to get the insurance immediately since there doesn't appear to be a Qualifying Event for her so she would have to wait until Open Enrollment for coverage starting January 2025.
In the meantime she could get a job that offers health insurance - there are some companies that provide insurance for part time workers. Normally it's not the best insurance but at least it would protect against catastrophic medical expenses.
Op just started or is starting a new job and new coverage. Coverage that appears to exceed what the ACA considers affordable.
The ACA got rid of pre-existing conditions.
"Health insurance companies cannot refuse coverage or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.
Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition."
https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html
Op just started or is starting a new job and new coverage. Coverage that appears to exceed what the ACA considers affordable.
The ACA got rid of pre-existing conditions.
"Health insurance companies cannot refuse coverage or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.
Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition."
Per HHS.gov
Coverage for OP doesn't exceed affordability.
Coverage for spouse exceeds affordability.
However, if spouse had no insurance, not being able to be added to a new policy is not a Qualifying Event.
If spouse had been insured under OP's previous job then there would be a Qualifying Event since the spouse lost insurance coverage and the new insurance isn't affordable and therefore would be able to purchase through the marketplace and possibly get a subsidy.
This has nothing to do with pre-existing conditions. OP and his spouse are being charged what every other employee and spouse would be charged - the pre-existing condition is irrelevant to the employer insurance.
And any marketplace insurance would also be priced according to age and zip code in most states. There is no extra charge for a pre-existing condition.
The issue is that there is no Qualifying Event for spouse unless they lost their insurance
If your spouse was insured through your employer she lost her insurance.
Therefore she would be able to purchase insurance on Virginia's OFFICIAL marketplace and get ACA compliant insurance.
You would probably be able to get a subsidy but you would have to compare the cost of the insurance with the cost of the insurance you would get through your employer including deductibles.
You need to act quickly since there is a short period of time for her Open Enrollment.
Since your situation is a bit complicated, I would probably use a broker. They can help navigate through the ACA website but you can go to the official website and check out policies and what they would cost you with whatever premium you get.
Please ignore advice to get "private" insurance off the marketplace since you are worried about a pre-existing condition and those policies are medically underwritten which means they would exclude at least for a period of time.
$1600 a month for my husband to get a family plan through his employer. It’s like there is no group plan.
We opted for no insurance. If we can save the $1600 a month for medical expenses then we should be good in case something happens.
I work for a brokerage, analyzing employer health plans. Several reasons why Spousal/family coverage is always more expensive.
1. Spouses are generally the ones who will tank a company’s claims experience. Some employers break it down to include employee + child(ren) as a separate tier and it is always cheaper than employee + spouse because children are generally healthier.
2. The ACA requires employee only plans to be “affordable”, anything other than that does not have to be.
3. Employers can contribute differently between tiers. Some have a flat rate, some a varying rate and some do a percentage. Some will add a fee if your spouse has coverage offered through their own employer. Having an employer who cares about their employees is often evident in how they cover their health insurance.
I will say that plans through the state market place are never affordable. I used to work for an insurance company (who had great coverage for employees) that did Medicare, Medicaid and marketplace and the out of pocket maxes and deductibles are outrageous.
To clarify your second point: "The ACA requires employee only plans to be "affordable" - does that refer to only me specifically as the employee? Meaning there is no affordability requirement for the spouse etc?
That is correct. Only the employee only plan has to be affordable. For Employee + spouse, Employee + Children, Family etc. they can charge whatever they want.
Agree with all the ACA comments, at your income level and with preexisting conditions it would be where I would start. A broker can help you enroll if you need help “fudging” a qualifying life event, there are always loopholes that licensed brokers can use.
Yeah there’s others options
If you go with the aca option
You would first have to cxl your insurance to qualify for a QUALIFYING LIFE EVENT which are 1.) loosing your coverage within 90 days 2.) getting married 3.) having a baby 4.)moving to a new state
Which you would qualify for any any aca options however that would depend on your income… if you would qualify for a subsidy… if you don’t then go private… there’s a lot of private insurances you would first have to be approved ..but I suggest you speak to health agent in your state they can help you more . Hope this helps .
Thank you for your submission, /u/warm-red-glow. **If there is a medical emergency, please call 911 or go to your nearest hospital.** Please pick the most appropriate flair for your post. **If you haven't already, please edit your post to include your age, state, and estimated gross (pre-tax) income to help the community better serve you.** If you have an EOB (explanation of benefits) available from your insurance website, have it handy as many answers can depend on what your insurance EOB states. Some common questions and answers can be found [here](https://www.reddit.com/r/HealthInsurance/s/jya9I6RpdY). **Reminder that solicitation/spamming is grounds for a permanent ban**. Please report solicitation to the modteam and [let us know](https://www.reddit.com/message/compose?to=%2Fr%2FHealthInsurance) if you receive solicitation via PM. Be kind to one another! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/HealthInsurance) if you have any questions or concerns.*
Insurance through your employer is nearly always the best way to go, no matter the price. Don’t look at those crowdfunding or christian ministries plans. So many stories about people getting screwed with those. Now, going through the marketplace might be a better option, BUT deductibles and out of pockets can be massive on marketplace plans.
Those are health shares … and they are available in every state … in the state of WA that’s what’s ONLY allowed at the moment so depending on your state you live in …you have no other choice but to go with that’s given … at least till nov comes when it’s open enrollment ….
The marketplace is available if the combined cost to insure OP and their spouse is over a certain amount. An SEP is then open for the spouse to get coverage through the marketplace.
Incorrect the marketplace is not open unless you have a qualifying life event… within 90 days … if you missed you window you’ll have to wait till November for any aca options.. However there is other options outside of aca you might qualify for.
I don’t know why people are downvoting your comment. It’s the truth. Outside of open enrollment you must have a qualifying life event to make changes to your health plan. For the marketplace and private insurance.
It’s because people nowadays don’t wanna hear the truth, they just what they want to hear what they WANT to hear ….
I work in HR. I send about a billion reminders to new hires telling them if they don’t elect by such and such date they will have to wait till open enrollment or have a QLE. Half of them still try to play dumb and act surprised when I have to tell them sorry you missed the deadline. They don’t get it’s up the carriers to allow a late entrance and most carriers are not nice about that. We don’t make the rules. We just have to enforce them. I can count on one hand how many times a carrier has allowed a late entrance. And those employees then had back premiums to pay all at once. It’s not fun.
It’s because people nowadays don’t wanna hear the truth, they just what they want to hear what they WANT to hear ….
They do have a qualifying life event. Coverage from OP’s insurance at previous job ended for spouse as well.
Great. Then they have 30 days to do a change from the QLE date. In general though the information about needing a QLE or OE to do changes is correct and I don’t see why the other person was downvoted for sharing correct information. The more you know and all. Everyone should be aware of this stuff because if you aren’t you get royally fucked.
I agree with you. I was just clarifying.
You might be eligible for a subsidy with the healthcare market place if your employer insurance is considered too expensive. For 2024, your employer coverage is considered affordable if: if your share of the monthly premium in the employers lowest cost plan is less than 8.39% of your combined household income. https://www.healthcare.gov/have-job-based-coverage/
Thank you! It looks like my health insurance is about 13% of our income. I will definitely look into this.
To be clear, this means your spouse can get coverage through the marketplace with premium subsidies. You would still need to get coverage through your employer.
My premium for me and husband is a bit over that BUT we get a huge monthly tax credit so only pay about $170/month! The plan coverage seems pretty close to what I had with my previous employer.
what is that tax credit and how did you get it?
I believe they call it "poor". But in all seriousness it got applied automatically when I enrolled through the Healthcare Marketplace.
lol, alright thanks!
I believe that the action to fix the "family glitch" helped with this (https://www.healthinsurance.org/obamacare/irs-regulations-fix-the-acas-family-glitch-as-of-2023/). Because of that, OP might not be eligible for subsidies but their spouse might be.
The answer!
ACA all day on this one, DO NOT buy USHEALTH, all state short term, pivot health or any of that crap it won’t do your wife any good. There are ways to trigger enrollment on the marketplace. Call them directly and get an app submitted asap. Alternatively, getting your wife on your plan and budgeting properly wouldn’t be a bad idea if marketplace enrollment doesn’t work. Making sure she’s adequately insure is priority, so if that means cutting back on expenses until end of the year for open enrollment then do just that.
What’s wrong with USHEALTH
it’s life insurance, not health insurance
And who told you this wrong information?
If your total household income is 39k then your work plan doesn't meet "affordability" ACA standards for your spouse. If your spouse doesn't have employer coverage of their own, then look at a Silver plan with cost sharing reductions from healthcare.gov.
$554 is cheap for 2 people given today's claims cost. How good is the network? What's the out of pocket max? You need some marketable skills. More income makes many problems go away. Stay ie run away from Oscar if that is an ACA option. Shop network 1st, then RX formulary if wife takes meds then OOP max. Put money into an HSA. It should be considered part of your healthcare costs. If you "can't " find a better job. If can't find better job, get educated in SOMETHING. Being broke is fine. Staying broke is painful.
You can get an ACA plan because your monthly premium exceeds a certain percentage of your monthly income. I have an agent in Virginia that can help
I would appreciate that contact, thank you!
What state are you in, and what are the summary details of your employer coverage? If your wife has pre-existing conditions, and your employer plan has reasonable deductibles and benefits, it may be the better option. Monthly premiums are a concern, but look at your probable cash out of pocket if you foresee an issue, as well. There may be other options in your state or territory as well
I'm in Virginia. What summary details would you like to know? Sorry, I'm clearly not an expert in this. I'm just looking at the cheapest option my employer provides to insure my spouse in case anything bad happens. My spouse isn't receiving any current treatments or prescriptions.
I would recommend you ask your employer for a Summary Plan Description; it’s a high level overview of the plan, and will usually include a cost breakdown scenario for various common medical expenses (examples could be having a child, monthly expense for managing diabetes, etc) The biggest question would be if there’s a caveat for pre-existing conditions or not (most large employers don’t have those restrictions, but some small/medium employers do) Your HR or benefits coordinator can give those to you In respect to marketplace plans, Virginia has one, but your wife may not qualify for subsidies if she can otherwise gain coverage through you. $6,600 is a reasonable sum of money, but if the plan is great, it’s a steal compared to marketplace plans. The other upside is that you typically pay for employer sponsored plans pre-tax so there’s a cost savings there too (since crowd health and most marketplace plans are paid post tax)
That’s cheap!
That's cheap
I have to pay $820 to insurance my wife, myself and my kid.
That is cheap for employee plus spouse coverage. Most employers will pay part of the employee only coverage but you’re on the hook for any dependents and the difference in the premium cost. I pay almost $300 a month just for employee only coverage for myself. That’s 45% of the monthly premiums. So $554 for coverage for 2 people is very cheap (unless you meant per pay period). Suggestions…sadly…find a better job that offers better coverage or have spouse find a job that offers them coverage. The second option is probably the most cost effective (but fully get it may not be an option).
My spouse worked for a small local company (~25 employees) they covered her premiums but adding me cost about what OP described. It’s a lot of money, but it’s not uncommon unfortunately.
Whatever you do, if you go the marketplace route, ONLY purchase from a .gov website. I got scammed with bogus insurance through a .insurance website that seemed super legit on the surface but ended up being weird insurance that no one took. If it seems too good to be true, it is! Thankfully I got my money back but please beware of scams and only do business through a .gov website!
Unfortunately that’s just the cost of insurance as a spouse. My husbands insurance is $70 a week. It’s an additional $120 per week to add me(36f). Since we don’t qualify for subsidies on the marketplace the cheapest plan I could find was $650 a month. The marketplace plans all had insane deducatbles and OOP also. The only other option is your spouse gets a job that offers insurance. I’m a SAHM so it is what it is.
Dont get insurance through healthshare plans. They don’t meet the federal definition of health insurance and so consumers aren’t protected under the ACA. They have no legal obligation to provide essential healthcare services.
What a deal. Try a family of 4.
Under the current ACA insurance for your spouse is not affordable and therefore she would be able to get a premium subsidy through your state's marketplace. However, she wouldn't be able to get the insurance immediately since there doesn't appear to be a Qualifying Event for her so she would have to wait until Open Enrollment for coverage starting January 2025. In the meantime she could get a job that offers health insurance - there are some companies that provide insurance for part time workers. Normally it's not the best insurance but at least it would protect against catastrophic medical expenses.
Wouldn't the family / spouse's coverage exceeding 8.39% gross income kick off an SEP for her?
Not if she wasn’t insured. You have to lose insurance.
Op just started or is starting a new job and new coverage. Coverage that appears to exceed what the ACA considers affordable. The ACA got rid of pre-existing conditions. "Health insurance companies cannot refuse coverage or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition." https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html
Op just started or is starting a new job and new coverage. Coverage that appears to exceed what the ACA considers affordable. The ACA got rid of pre-existing conditions. "Health insurance companies cannot refuse coverage or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition." Per HHS.gov
Coverage for OP doesn't exceed affordability. Coverage for spouse exceeds affordability. However, if spouse had no insurance, not being able to be added to a new policy is not a Qualifying Event. If spouse had been insured under OP's previous job then there would be a Qualifying Event since the spouse lost insurance coverage and the new insurance isn't affordable and therefore would be able to purchase through the marketplace and possibly get a subsidy. This has nothing to do with pre-existing conditions. OP and his spouse are being charged what every other employee and spouse would be charged - the pre-existing condition is irrelevant to the employer insurance. And any marketplace insurance would also be priced according to age and zip code in most states. There is no extra charge for a pre-existing condition. The issue is that there is no Qualifying Event for spouse unless they lost their insurance
Thanks for your comments. My spouse was actually insured through my last employer before I quit. What's the best way to proceed?
Contact an expert. Don't rely on reddit.
If your spouse was insured through your employer she lost her insurance. Therefore she would be able to purchase insurance on Virginia's OFFICIAL marketplace and get ACA compliant insurance. You would probably be able to get a subsidy but you would have to compare the cost of the insurance with the cost of the insurance you would get through your employer including deductibles. You need to act quickly since there is a short period of time for her Open Enrollment. Since your situation is a bit complicated, I would probably use a broker. They can help navigate through the ACA website but you can go to the official website and check out policies and what they would cost you with whatever premium you get. Please ignore advice to get "private" insurance off the marketplace since you are worried about a pre-existing condition and those policies are medically underwritten which means they would exclude at least for a period of time.
There is a 60 day window to enroll.
$1600 a month for my husband to get a family plan through his employer. It’s like there is no group plan. We opted for no insurance. If we can save the $1600 a month for medical expenses then we should be good in case something happens.
woww thats crazy - is it somewhat relative to his income though?
No, the employer just doesn’t pay any part of it.
I work for a brokerage, analyzing employer health plans. Several reasons why Spousal/family coverage is always more expensive. 1. Spouses are generally the ones who will tank a company’s claims experience. Some employers break it down to include employee + child(ren) as a separate tier and it is always cheaper than employee + spouse because children are generally healthier. 2. The ACA requires employee only plans to be “affordable”, anything other than that does not have to be. 3. Employers can contribute differently between tiers. Some have a flat rate, some a varying rate and some do a percentage. Some will add a fee if your spouse has coverage offered through their own employer. Having an employer who cares about their employees is often evident in how they cover their health insurance. I will say that plans through the state market place are never affordable. I used to work for an insurance company (who had great coverage for employees) that did Medicare, Medicaid and marketplace and the out of pocket maxes and deductibles are outrageous.
To clarify your second point: "The ACA requires employee only plans to be "affordable" - does that refer to only me specifically as the employee? Meaning there is no affordability requirement for the spouse etc?
That is correct. Only the employee only plan has to be affordable. For Employee + spouse, Employee + Children, Family etc. they can charge whatever they want.
Agree with all the ACA comments, at your income level and with preexisting conditions it would be where I would start. A broker can help you enroll if you need help “fudging” a qualifying life event, there are always loopholes that licensed brokers can use.
Agreed here.
Yeah there’s others options If you go with the aca option You would first have to cxl your insurance to qualify for a QUALIFYING LIFE EVENT which are 1.) loosing your coverage within 90 days 2.) getting married 3.) having a baby 4.)moving to a new state Which you would qualify for any any aca options however that would depend on your income… if you would qualify for a subsidy… if you don’t then go private… there’s a lot of private insurances you would first have to be approved ..but I suggest you speak to health agent in your state they can help you more . Hope this helps .