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October 2014 Moms
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Insurance Question

atravelleratraveller member
in October 2014 Moms
This may vary state to state - so if no one knows for sure, no worries. I live in NY State and was told by a sales person for my insurance company that I should not put my child on my family plan but actually get the child set up for Child Health Plus. This is normally grouped in with medicaid and lower income insurance but is actually something anyone can apply for. According to the woman I spoke with - anyone can sign up for it, just if your income is higher you pay the full premium versus a subsidized premium. But according to what I found out - that full premium is still much lower than what I would pay on a family plan AND - once the premiums are paid, there are no deductables at all- and all appts, bloodwork, etc...are covered including dental until the child is 18. I was told also that pretty much all doctors take this insurance. I'm a skeptic and when things sound too good to be true I worry but I was told by this sales person and at least one subsequent person I spoke to who does the calendar for the hospital childbirth classes that it's actually the best insurance you can have for your child and its just that because it is grouped with Medicaid, etc....many people just don't know about it.  I was wondering if anyone on here had any info or knew anything about it? Figured worth checking.  I don't get employer paid for insurance - but rather get a stipend (because I work remote) and get insurance through the state exchange - I used to use the local chamber of commerce to get individual insurance through before the exchanges were set up. I'm not sure if my employer is going to bump up the stipend to cover my child's insurance as well, so may be on my own for that.

Lilypie - (urRB)


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Re: Insurance Question

  • Lauren1184Lauren1184 member
    Sorry, I live in NY too but I haven't heard of this.  I've been at the same company since I graduated college and they provide us with insurance.  Maybe you can ask your current doctors or future pediatrician if they take that insurance, they might have more information that could be helpful.

     

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  • bumpuser10309732bumpuser10309732 member
    A lot of times it's cheaper for health insurance as an individual than as a family. Which is dumb, but completely true. I would just check to see what doctors you want to use for LO to be sure they're in coverage. I would just pay attention to max out of pocket deductible and ease of use between providers. I'm not personally familiar with it, but normally NY state has really good coverage for health insurance plans. I don't think it's one of those too good to be true situations. Health insurance is a pain in the ass no matter which one you use. :-) Also you should get the tax credit then, correct?
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  • atravelleratraveller member
    MrsBabe614 said:
    A lot of times it's cheaper for health insurance as an individual than as a family. Which is dumb, but completely true. I would just check to see what doctors you want to use for LO to be sure they're in coverage. I would just pay attention to max out of pocket deductible and ease of use between providers. I'm not personally familiar with it, but normally NY state has really good coverage for health insurance plans. I don't think it's one of those too good to be true situations. Health insurance is a pain in the ass no matter which one you use. :-) Also you should get the tax credit then, correct?
    yeah - I'll just have to look closer into it. And nope, I don't get the tax credit because I make too much money to get the subsidy - I'm part of the group of independent workers (contractors) that essentially got screwed by affordable healthcare act - in that I don't qualify for subsidies and end up paying the highest premiums as a result. My health insurance was better before the act, as the premiums were about the same but more services were covered in full - now the companies are nickle and dimeing with co-pays. At least my main employer pays most of the premium through a stipend, so my out of pocket costs are not insane.

    Lilypie - (urRB)


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  • bumpuser10309732bumpuser10309732 member
    atraveller said:
    MrsBabe614 said:
    A lot of times it's cheaper for health insurance as an individual than as a family. Which is dumb, but completely true. I would just check to see what doctors you want to use for LO to be sure they're in coverage. I would just pay attention to max out of pocket deductible and ease of use between providers. I'm not personally familiar with it, but normally NY state has really good coverage for health insurance plans. I don't think it's one of those too good to be true situations. Health insurance is a pain in the ass no matter which one you use. :-) Also you should get the tax credit then, correct?
    yeah - I'll just have to look closer into it. And nope, I don't get the tax credit because I make too much money to get the subsidy - I'm part of the group of independent workers (contractors) that essentially got screwed by affordable healthcare act - in that I don't qualify for subsidies and end up paying the highest premiums as a result. My health insurance was better before the act, as the premiums were about the same but more services were covered in full - now the companies are nickle and dimeing with co-pays. At least my main employer pays most of the premium through a stipend, so my out of pocket costs are not insane.
    That's insane! We've always had co-pays where I'm at. I agree that the health insurance since has gone down hill. Which is saying a lot because it wasn't spectacular before the fact! I've wasted a lot of time arguing about health insurance coverages with the company. Just stupid.
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  • bennikkibennikki member
    atraveller said:
    MrsBabe614 said:
    A lot of times it's cheaper for health insurance as an individual than as a family. Which is dumb, but completely true. I would just check to see what doctors you want to use for LO to be sure they're in coverage. I would just pay attention to max out of pocket deductible and ease of use between providers. I'm not personally familiar with it, but normally NY state has really good coverage for health insurance plans. I don't think it's one of those too good to be true situations. Health insurance is a pain in the ass no matter which one you use. :-) Also you should get the tax credit then, correct?
    yeah - I'll just have to look closer into it. And nope, I don't get the tax credit because I make too much money to get the subsidy - I'm part of the group of independent workers (contractors) that essentially got screwed by affordable healthcare act - in that I don't qualify for subsidies and end up paying the highest premiums as a result. My health insurance was better before the act, as the premiums were about the same but more services were covered in full - now the companies are nickle and dimeing with co-pays. At least my main employer pays most of the premium through a stipend, so my out of pocket costs are not insane.


    I feel your pain!  The ACA screwed us as well!  No subsidy, same premium for less care covered, and fewer provider choices.  Now I have to pre-certify things, WTF is that about?!  You have several billing statements that show I'm pregnant, I'm participating in your healthy mother's program (for the $250 Visa card) but I still have to pre-certify my planned hospital for birth, or you can refuse to pay the labor and delivery costs?!  In the event that there is an emergency, and I give birth at a different hospital it's covered, but for whatever reason, I have to let them know the hospital I'm planning to give birth at.  Ugh, I could go on!

    On your original question, my SIL is a teacher (in MN), so her insurance is covered by her employer, but the out of pocket expense to cover my brother, niece, and nephew would have left her with like $250 take home pay per month, so she stuck the kids on a program like the one you're talking about (I'm not sure of the name), and my brother got his own plan through the exchange.  It's cutting their monthly costs down dramatically, but I don't know about premiums, provider options, and coverage.  My brother's a farmer, so their income can fluctuate dramatically (seriously by over $100K sometimes), so they don't receive any subsidy until the end of the year (if they qualify) which they use to lower their tax bill.

    Me: unexplained infertility - annovulatory DH: testicular cancer survivor!! TTC since June 2009 BFP May 11, 2012 EDD January 24, 2013 June 1, 2012 - first u/s, heartbeat 124 BPM!! June 22, 2012 - heard the heartbeat 9w1d 181 BPM!! 24 hours of labor, 4 1/2 hours of pushing, and IT'S A BOY! Welcome to the world my miracle, we prayed and prayed for you, and we can't believe you're here!
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  • golfingdarwinfishgolfingdarwinfish member
    I live in NY and have never heard of this, but am going to look it up out of curiosity.... My company covers our full insurance premium and we only have co-pays because I opted for a high out-of-network coverage plan, otherwise we probably wouldn't have any period. I didn't know that one can even apply for healthcare related tax credits, but assume our accountant would have mentioned it. We never qualify for anything!
    Loss Blog (finally updated)

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    5 cycles of "TTC" - 3 intentional, 2 not so intentional.  5 BFPs.  My rainbow arrived 10/15/14.
    TFMC 08.02.13 at 19+ weeks. Everyday I grieve for my little Olive.

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  • atravelleratraveller member
    VCGolfNYC said:
    I live in NY and have never heard of this, but am going to look it up out of curiosity.... My company covers our full insurance premium and we only have co-pays because I opted for a high out-of-network coverage plan, otherwise we probably wouldn't have any period. I didn't know that one can even apply for healthcare related tax credits, but assume our accountant would have mentioned it. We never qualify for anything!

    @VCGolfNYC - yeah, I'm upstate, so not sure how it is throughout the state. We have MVP - and it was an MVP sales rep that told me about it and then as I said, the woman at the hospital who schedules birthing classes said she has it and its great. RE: tax credits - yeah if you get employer insurance you probably woudn't have heard of it - as the subsidies are based on exchange plans....we don't qualify with our combined income. I'm getting ready to schedule some pediatrician interviews in the next few weeks and will probably ask these doctors if they take this insurance, etc.... and will be doing more research to see if it is really legit and offers the full coverage we will want.

    Lilypie - (urRB)


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  • IrishHoney123IrishHoney123 member
    One of my caps as an ER nurse is case management, and I assist families in finding insurance. These programs are legit, and are funded in part from your own paycheck (medicaid taxes), so keep that in mind. If that doesn't bother you, then go for it.
    BabyFruit Ticker 
    Married 8/09 to my love
    Our little shamrocks:
    M~4/11   W~12/12   E~due 10/14

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