Working Moms

Anyone have private health insurance/ACA or something like that?

My husband is a small business owner.   I work in Corporate America so we rely on my health insurance from my employer.

We are getting to a point where either I could work with him in the next year or he said if I want, do something other than corporate America (I am so sick of cubicle life).  Financially, in the next year, we'll have no debt other than our mortgage/living expenses (no car payment, student loans, credit card debt).  I used to own my own wedding planning business and think of getting back into that at times.  I stopped because my husband's business idea was too good for him not to do - so glad he started it!

The only thing scaring me is insurance.  With 2 little kids (though we are done having babies) and histories of type 2 diabetes, cancer, etc. in our families, I'm terrified to not have great health care.    But is slaving away in a cubicle forever my only solution for good healthcare??
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Re: Anyone have private health insurance/ACA or something like that?

  • That is the whole point of the ACA, to give everyone more options.  Definitely check out your state's insurance exchange website to see what is available.  There is also a federal exchange.  If your husband expects to hire more people in the future he could also look into getting a small group plan for his business. 

    Buying insurance on the exchange will cost more than getting coverage through your employer, for sure, because your employer is likely subsidizing well more than half the cost right now.  So it is a good idea to get a sense of the plans and prices before you make any major decisions.  Good luck!
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  • We looked into it and it was not worth it for me to stop working; my husband is also self-employed but does not have employees to qualify for business insurance.  The affordable care act is a joke if you live in a HCL area.  For a family of four you have to make less than 92K to be eligible for any kind of help otherwise they consider 10 percent of your pay to be affordable well I don’t find 9 or 10K a year for insurance with high deductibles affordable when I live in an area with high taxes, housing etc.  Private insurance was also not a good match for us so for now it makes more sense for me to work.  Maybe down the road if things change with the ACA we can reconsider. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

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  • IMO very few people understand the true cost/expense of health insurance and how much their employers are actually subsidizing. And even fewer, determine what there actual full compensation is from their employer.

    If I were in your shoes I would determine what my yearly compensation amount was (salary, bonus, vacation, 401k or retirement matching, healthcare, HSA matching or contribution amount, life insurance etc.) subtract taxes from that amount and then determine if we as a family could afford to live without that amount while purchasing the benefits that we would still need.

    My benefit package as outlined above is equal to roughly 30% of my actual salary. I don't think we would ever be able to replace that or cover what it provides for us without a seriously large increase in DH's earnings.

  • DiveFrog said:

    IMO very few people understand the true cost/expense of health insurance and how much their employers are actually subsidizing. And even fewer, determine what there actual full compensation is from their employer.

    If I were in your shoes I would determine what my yearly compensation amount was (salary, bonus, vacation, 401k or retirement matching, healthcare, HSA matching or contribution amount, life insurance etc.) subtract taxes from that amount and then determine if we as a family could afford to live without that amount while purchasing the benefits that we would still need.

    My benefit package as outlined above is equal to roughly 30% of my actual salary. I don't think we would ever be able to replace that or cover what it provides for us without a seriously large increase in DH's earnings.

    I agree 100 percent.  So many of my friends only look at that bottom line how much do I bring home.  I was once offered a job making 10K more.  After running the numbers pension( my company has a pension), 401K match, and healthcare I would have been losing money for a 10K "raise".


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  • I have to agree. I recently saw how much DH's company paid for our healthcare premiums for a family of 4, and it was like 20K. I think it was on one of our tax documents.
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  • Thanks a lot for the information, ladies.  I totally agree and that's why it's my biggest concern.   I realize that it's not just my paycheck that needs to be replaced, but all the other benefits that make up the total compensation like health insurance and my 401(k).   I know I can replace SOME of the latter by contributing to an IRA (though there is no match of course) but I'm not sure I can pull off the healthcare which is why I was hoping to get some insight from anyone actually using the ACA or paying for private insurance.   I guess I'll see where we are in a year or so.  

    DH does have employees (5 so far) for his small business so maybe when all the chaos around the ACA settles down we can look into small business coverage in the next 6-12 months.
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  • Yes, there will be some limited exceptions but the average large employer (500+ employees) covers between 70% and 80% of the cost of coverage.  So for most, buying an individual policy will cost more.
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  • @haygurlhay  do you have a family plan or did you just get coverage for you and your husband and then coverage for the kids is a state plan or something else?  Also, I thought the price was based on your income as well, is that true?

    My employer's insurance is "good"  but, for example, my preferred birth control is not covered and costs about $115/month!!  So I'm paying that per month on top of my out of paycheck amount  which I find crazy.  We have no other Rx costs thankfully.   I'll really have to look into the ACA marketplace in a few months to see what's available.   
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  • MommaP12 said:
    @haygurlhay  do you have a family plan or did you just get coverage for you and your husband and then coverage for the kids is a state plan or something else?  Also, I thought the price was based on your income as well, is that true?

    My employer's insurance is "good"  but, for example, my preferred birth control is not covered and costs about $115/month!!  So I'm paying that per month on top of my out of paycheck amount  which I find crazy.  We have no other Rx costs thankfully.   I'll really have to look into the ACA marketplace in a few months to see what's available.   


    Does your employer cover birth control, just not your preferred type? or doesn't cover BC at all?

    I thought (but could be wrong) that the ACA mandates that ALL plans (including employers) must provide birth control coverage. However, if it is just that you prefer a brand name BC drug versus a comparable generic, I'm not sure even a private plan from the exchange would provide coverage for that. You would still end up paying the $115/month for the name brand RX.

    My experience is that if there is a generic available for any RX that is the cost the insurance will cover. Name brand drugs are always an added expense.

  • DiveFrog said:
    MommaP12 said:
    @haygurlhay  do you have a family plan or did you just get coverage for you and your husband and then coverage for the kids is a state plan or something else?  Also, I thought the price was based on your income as well, is that true?

    My employer's insurance is "good"  but, for example, my preferred birth control is not covered and costs about $115/month!!  So I'm paying that per month on top of my out of paycheck amount  which I find crazy.  We have no other Rx costs thankfully.   I'll really have to look into the ACA marketplace in a few months to see what's available.   


    Does your employer cover birth control, just not your preferred type? or doesn't cover BC at all?

    I thought (but could be wrong) that the ACA mandates that ALL plans (including employers) must provide birth control coverage. However, if it is just that you prefer a brand name BC drug versus a comparable generic, I'm not sure even a private plan from the exchange would provide coverage for that. You would still end up paying the $115/month for the name brand RX.

    My experience is that if there is a generic available for any RX that is the cost the insurance will cover. Name brand drugs are always an added expense.

    @DiveFrog I thought the same thing as you - that all BC was supposed to be covered, but that is not the case and a very common misunderstanding (I certainly misunderstood it!) which is really disheartening.

    It's a name brand but to be honest, we're done having children so I'm putting the pressure on DH to take care of things so that it's not an expense very long!  
    \:D/
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