Ladies, I need your help! Just found out we are losing our Health Insurance...

izzetoot · May 2014

Hi ladies - I'm hoping somebody out there might be able to ease my panic stricken mind with some insight as to where I should start looking for health insurance for my family. Currently, I am covered through my husbands insurance and LO is scheduled to be after he is born. Both my DH and I also have minor medical issues which require somewhat frequent trips to various docs and also monthly prescriptions. And with the new guy here soon, we can add pediatrician to the list

Here's the problem, DHs restaurant group has been "fired" by the company/hotel that brought them in so he is no longer employed by that group. The new company (and his now current employer) is most likely going to lay everyone off and start from scratch. On the bright side, there is another restaurant group that has been trying to hire DH for a while that he contacted immediately (he's actually meeting with them right now). But it is a very small organization that does not offer insurance and he will have a significant pay cut, like $20k. I work full time, also by a small company, that also does not offer health insurance.

The new company is aware that I am on his insurance plan and due in the next 2-4 weeks, however not sure if they even care as he is just one of many employees they are sifting through right now. Even though he is a salaried manager, high up on the totem pole. When the lay off happens, we will be offered Cobra for at least 6 months (I assume), so I will have a little time to shop around and Obamacare will be available for enrollment again in November. Are any of you ladies currenly enrolled in Obamacare and do you have any advice or input? Otherwise, any ideas as to the best route to start looking for affordable health insurance for the three of us, especially considering the potential pay cut?

Thank you in advance for any knowledge you can share with me. We've never been in a position to have to look for private insurance so I'm kind of at a loss. Im just trying to keep my cool for now and not stress out in the last few weeks of pregnancy, but it has not been easy...

otter1103 · May 2014

First off, I'm sorry about all of this. If you can swing the COBRA insurance for the next couple of months to get to you through delivery, that would probably be the easiest as far as coverage goes. Your plan really won't change so no potentially bumpy transition or potential new deductible. Then shop around during that time. Also research a bit, you MIGHT be able to enroll early due to a qualifying event (loss of current coverage).

jshrop · May 2014

You should be eligible to enroll in health marketplace due to changes in work coverage and loss of current insurance. Any significant life change like this should permit you to enroll. You can also look to enroll ing privately, not in the marketplace. Contact a broker in your area and they will be able to assist you will enroll ing in a plan. Good luck!

elsa1688 · May 2014

jshrop said:
You should be eligible to enroll in health marketplace due to changes in work coverage and loss of current insurance. Any significant life change like this should permit you to enroll. You can also look to enroll ing privately, not in the marketplace. Contact a broker in your area and they will be able to assist you will enroll ing in a plan. Good luck!

Wss. You have a change in circumstances so you will be eligible.

MissBHaven1024 · May 2014

You definitely need to go to healthcare.gov and apply for a plan through the Affordable Care Act. You've had a qualifying event (loss of work) that would allow you to enroll.

If you choose to not go that route, then I would advise that you look into pregnancy medical through your state. Difference between the two is one you pay premiums, co-pays, and doctor's bills for; the latter, you don't.

Good luck though! I hope you can get it resolved quickly!

chloephoebecali · May 2014

I am delivering under Cobra, but shortly after Dh's new insurance will kick in. Maybe your Dh will find something new before it becomes an issue?

hjl050308 · May 2014

I'd start to research the ACA (Obama care) in case COBRA premiums are too expensive, which they tend to be high. You have a life changing event and should still be able to enroll.

rainbowdashh · May 2014

Definitely look into the ACA. You should be eligible to enroll because of your husbands change of employment. COBRA premiums are insanely expensive!

izzetoot · May 2014

Thanks ladies, I will def look into ACA and check out our eligibility because of the loss of employment. Didn't even think about that! Also didn't realize Cobra was so expensive, so thats worrisome. I will be covered during the delivery as we are expecting the change to happen at the current employer in about 2 months. Im mainly worried for all of the appts post delivery and making sure our new pediatrician and current docs will be in network with whatever insurance we do end up with. We are paying roughly $500 a month now for the 'all inclusive' insurance bc of my health issue + pregnancy and were planning on dropping it back to something less involved post delivery. So we are used to the big $500 a month payment now, but thats also with our current income.

jshrop · May 2014

Depending on your income you may be eligible for some "subsidies" through ACA. Good luck in finding coverage.

MrsCase1 · May 2014

I have been both uninsured and on COBRA while pregnant so I feel OK to answer this.

Thsi is going to sound really, really rotten of me but it is not intentional, as I am not advocating "milking the system" but rather trying to spare you a medical bankruptcy.

I would keep the COBRA for the duration of your pregnancy and the first couple of months for shots. My pedi billed insurance $1,000+ for well baby visits with shots and when I paid OoP it was typically around $150 for the visit plus $10/shot.

After that, I would consider holding off on insurance if you can't find something reasonably priced privately, which I am thinking if you're like literally everyone I know who has tried the exchange, you won't be. The income qualifications are ridiculous at best and do not take into account vital factors such as debts, mortgages, etc.

When we were uninsured I was able to call providers and furnish them with pay stubs and bank statements. All but one reduced my debt based on reduced income and were willing to write off a portion, or at the very least, put me on a realistic payment plan. I will be paying some of them $25 for the rest of my life but I am not bankrupt.

The laws are changing for 2014 and you now need to spend even more to be able to "write it off" on your own taxes. Don't get me started. These are not the true numbers because I forget what they are but my CPA used the example of "You used to be able to write off any amount of 5% of your income now you have to spend over 15% to get credit." Again, not the true numbers but the jump was pretty astronomical. So you basically have to spend a small fortune before receiving a reprieve. The year I delivered Lincoln uninsured and on COBRA I spent approximately $13,000+ on medical expenses and premiums for a 9 month period.

WITH insurance, I spent $3,800+ on medical expenses AFTER monthly premiums last year and that was with zero incidents.

All this to say, don't be afraid to call people and have them work with you. There is no shame in it, and depending on the type of hospital, they encourage handing out assistance because it helps them keep their tax status if they're non-profit.

MrsCase1 · May 2014

On the subject of COBRA payments. We had decent coverage through my husband's employer. For me and Lincoln alone (couldn't afford to cover DH) we paid $1,500/month. Last time my husband switched jobs the COBRA was closer to $2,000 so we skipped it altogether.

MrsCase1 · May 2014

P.P.S.S. If you have general questions, the people at esurance.com answer everything (for free) and they'll tell it like it is. They were a great resource to me in 2011 even though I didn't end up buying a plan through them.

izzetoot · May 2014

Thanks @MrsCase1 that is a ton of useful info. I think if one of us had to skip out on medical insurance it would probably be me as I wont need nearly as much attention post baby, so thats an option for the short term. I don't think we would financially qualify for any kind of income based relief either. DH is going to try and stay on at the current job (which of course has excellent insurance coverage) for as long as possible. And before it switches to Cobra we will milk it if all its worth: vision, dental, check ups, etc anything I knock out not knowing how long we will have to go without. About how many months of check ups and appts can I expect with LO after delivery? Assuming and god willing everything goes smoothly and there are no major medical concerns with him? I completely just passed on the meeting the new pedi ahead of time bc we didn't have any time nor he any available appts till May. So we've never met him in person to get this info

izzetoot · May 2014

krptcmschfmkr128 said:

Look into Medicaid, also. They will (usually) help you with finding ACA coverage if you're ineligible for Medicaid. So, two birds, one stone.

If you do go the ACA route, I'd be curious to know what sort of costs you get (if willing to share). I've only heard horror stories from friends who've come across outrageous coverage under ACA, so I'm interested in if someone I "know" finds something different.

Will keep you posted, i've done a little research already and found that outside of ACA most companies offer pretty similar rates. For our income and state (TX) we would be paying bt $500-800 mo (to have one of the more basic plans) for all 3 of us with a $13,000 family deductible. That of course includes the largest minimums for hospital visits, er, doc office, pharmacy, etc. Which little by little will peck away at the $13000 but I would imagine is pretty hard to surpass in one year.

MrsCase1 · May 2014

I am also in TX!

I would say COBRA is worth it for the first two months of pedi visits because they go SO often!

I didn't think we would qualify for financial aid, either but we did. Not through the government, but through all the private providers. According to the government we're wealthy (LOL) but hospitals and such look at other factors. TX is a tough state to get benefits from in terms of government assistance. We qualified for literally nothing. My husband was unemployed and we couldn't even get WIC because we had too much in our savings account (LOL again).

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Ladies, I need your help! Just found out we are losing our Health Insurance...

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