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Has anyone looked into buying health insurance through the Marketplace instead? - Seriously Wondering

Posted: Nov 05, 2014

I mean, Nuance ins doesn't cover anything really. It's only in case of something catastrophic and then you'd better be able to pay $5000 out of pocket right? I mean we have to pay for everything until we hit $5000 just for the insurance to even start paying for anything. Right? Is Obamacare better than that? If it is, it's not affordable at all.

Oops, meant isn't and -sm - Seriously Wondering

[ In Reply To ..]
And how do you figure it out when we don't know what we will make from week to week?

Only you can do the research - It is possible

[ In Reply To ..]
In my state, a single person making $1500 per month could qualify for the expanded MA coverage. You really need to do the work and go to your state's website and plug in your numbers. My state has "assistants" you can contact if you need help.

There might be different options, i.e., with a child, you might both then qualify for a subsidy, or you could put your child on the Obamacare and you could take company insurance, etc. I am sure the "assistant" could answer your question regarding options and variable income.

Unless you're income is extremely low, low enough sm - acuteMLS

[ In Reply To ..]
possibly for Medicaid, you won't get the subsidy to help pay.

I couldn't afford to pay the whole premium on the Marketplace myself so I took the HDHP insurance choice (low-cost one)

Insurance - Alice

[ In Reply To ..]
Last year, i looked into this. I am over 60, but not yet 65. For just myself, the lowest premium available was $445 per month with $6000 deductible. For myself and one adult child under age 26, it would have been $641 per month and $12,000 deductible. This was based on total household income of $1500 per month. So, they expected me to pay 1/3 or more of my monthly income in health insurance premiums PLUS deductible? I'm not sure who would consider this "affordable", maybe people who make a lot more money that I do.

I think it is different for each state, regardless of the Medicaid expansion thing. I do not know about HDHP or whatever that is and would appreciate hearing more about that.

Careful when choosing this. If you visit the doctor or have sm - acuteMLS

[ In Reply To ..]
regular lab tests/imaging OR take medications that aren't on the "maintenance" list, you have to pay 100% out of pocket for everything, including drugs until deductible is met.

My only medical expenses right now are 2 meds that are on the maintenance program with CareMark and 2 specialist visits a year, less than $200 for doctor visits.

If you take meds on the maintenance program, you are only required to pay copay and do not have to meet the deductible first. You also can have a HSA to contribute to on a pre-tax basis to help pay all the out-of-pocket you'll have with both plans.

HDHP is only for a generally healthy person whose major expense is drugs that happen to be on the CareMark program.

Also, after 2013, I stopped going to the 100%-covered sm - acuteMLS

[ In Reply To ..]
doctor visits for the yearly physical and mammogram.

Call me stupid, but all those visits did previously was cause me to have additional testing that cost me a TON OF MONEY and wasn't covered since I had a deductible (I was on the PPO plan).

I fully expect that I will die of some disease that is easily controllable if caught early because all this new insurance has done is discourage me from going to the doctor at all due to having to have additional views on mammograms or an EKG, stress test, etc. My 2 doctor visits are for med refills and I always say I'm fine when I go.

$2000 deductible, same premium - but

[ In Reply To ..]
but with $1500/month income, you would receive a subsidy making the cost next to nothing (at least in my state).

Did you apply the subsidy?

Utilize the services of an ACA Navigator to help you find the right plan - for you and your situation.

[ In Reply To ..]
Most healthcare facilities have a person trained as such.

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The caveat is, if your employer offers you insurance, you really do not qualify to purchase a plan in the Marketplace. So, you could drop down to part-time hours with Nuance (this company cannot keep you busy full-time anyway long term the way they ship off all our work to "Indian partners"), and then you would qualify. If you still need full-time income get another part-time gig.

The 50 states have implemented the ACA in different ways; therefore, you may or may not qualify for any of the subsidies. (Sadly, this is more a reflection of your state's politics than it is a reflection of the ACA Marketplace plans, though those states' governors typically just blame it on a "bad idea called Obamacare"). Anyhoooo, I digress.

Bottom line, there is just no way for anyone on this site to help guide you through an ACA process or even offer any pat answers, because all of our options are likely as personalized as our own health histories.

The beautiful part? ACA made it impossible for any insurer to deny you coverage based on any pre-existing medical condition. And, it can never be taken away from you (like it does when you change employers).

Become an IC then you will qualify for something. - It might be better or it

[ In Reply To ..]
might be worse. It's worth a try. Just apply through the Marketplace as a self-employed person and estimate your income. Sometimes the premium will be the same but the deductible will be much less as will be the out of pocket. Doesn't hurt to try.

MARKETPLACE...Complicated but they have calculators... - anon

[ In Reply To ..]
I am no expert FOR SURE. I think you will hear more on this board after tax time. It is very confusing. You cannot get health care through the Marketplace if your employer offers a "qualified" health insurance plan that you qualify for. For Nuance you have to work less than 30 hours a week to not be offered coverage. I have no idea if their plan is a "qualified" plan.

There are calculators, both federal and state for the Marketplace. Premiums are based on your age, smoking, and what level of coverage you choose. Bronze, silver, gold, platinum$$. You can compare plans and weigh your options.

The federal government subsidizes your premiums if you make less than 400% of poverty level. The poorer you are, the more they subsidize. You have to estimate your income. If you underestimate you may have to pony up at tax time. This is what I am facing, maybe...update after tax time!!

Since I am older but do not have, as yet, chronic health conditions, I chose the bronze plan with lower premiums but worse coverage (6000 deductible) The government picks up almost all of my premiums. I put money away every month to pay cash if I need to go to the doc or labs. I guess I get 3 "sick" visits a year and a yearly exam which I have not used because if the sick visit includes labs or x-rays, you have to pay that. They only cover the office visit. You get a mammo and colonoscopy, but, again, if they need further tests done or if they pull a polyp, you have to pay$$$. However if you get seriously ill, 6,000 out of pocket may not sound so bad after all.

I chose bronze for lower premiums because premiums are not counted for your 6,000 deductible. Since I do not go to the doctor a lot it seemed the right choice for me. 6,000 a year if I get hit by a bus or cancer, practically 0 if I stay healthy.

The health insurance companies are gouging big time as far as I can tell. They want 550$ a month for my bronze plan with lousy coverage and sky high deductible, what I would call a "catastrophic" plan. Customer service tells me the premiums are all going yet higher this year.

Thanks everybody. It's so complicated not knowing what I'll make. - Seriously Wondering

[ In Reply To ..]
I was just wondering if anybody had done it and it worked out better. I'm gathering from what's been said the answer is probably just about the same. If this doesn't wake us up to get out of this profession, I don't know. It's got to go down the tubes when people don't want to get anything done anymore, me included and I do have some big time health issues. I haven't seen my regular doc all year, haven't had blood work.

Health Insurance - Anonymous

[ In Reply To ..]
I have checked and can get much, much better insurance for just about the same cost, basically no deductibles, copays at the doctors only no deductible and excellent prescription coverage. Just went in to do my re-enrollment and opted out of the medical. You can also continue to contribute to your FSA tax free and pay your insurance premiums from you FSA card.

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