My wife started a new job, and the 4 insurance plans they offer are a bit confusing

[glorydaz]

@boozle Is it possible to get decent coverage OUTSIDE of a company? Our current insurance, through my company is about $900 a month, but offers higher OOP and less coverage than these plans.

 

[boozle]

@glorydaz I'm not sure you can buy ACA coverage if coverage is available through your employer; you might have to have NO option through your employer to be eligible for coverage. Check the Marketplace website and you will find explanation of eligibility to buy coverage.

You can always check with an insurance broker to see about buying privately. There are policies you can purchase that are neither ACA nor employer-sponsored....but I honestly don't know if they would offer better coverage or lower premiums. You could tell a broker what your current policy costs & covers, and ask them to compare to other products to find out if you can do better. Depending on your situation, you could also investigate whether there is group coverage available through a co-op arrangement affiliated with your church/religious group. Since you're already laying out nearly $11,000 in annual premiums alone, and would still have to satisfy a deductible before coverage kicks in, look at your overall cost as a baseline for comparison. You can also look at HMO vs PPO plans, if you're willing to stay within a specific network or obtain pre-approvals in exchange for less overall OOP.

It seems like 2024 insurance costs have shot through the roof, AND coverage is generally not nearly as comprehensive. I guess that's where an HSA or FSA would help to fill the gap. I'm a retiree now on Medicare + a supplemental policy; prior to that I had employer-sponsored coverage, then a couple years of ACA coverage after early retirement. HSA's were a newer thing, so I'm not familiar with how all that works...but I would definitely look into it if I was in your situation. Good luck!

 

[glorydaz]

@boozle Thank you for taking the time to reply! That was helpful.

 

[minnieys]

@glorydaz When healthcare.gov open enrollment comes around in the fall I'd run the numbers to see what it looks like to have each parent with employee only coverage and the kids on a healthcare.gov plan.

Wouldn't hurt to run the numbers now on what it looks like to have one of you as employee + children and the other employee only coverage via your employers

 

[talitha2014]

@glorydaz I didn't look at the details. But, you could look into an additional policy for accidents

My sister has three teenage athletes. She has a high deductible health insurance plan through her employer for her family. If something bad came up, thry have savings they could tap into. But, they also got an additional private policy to cover injuries.

Myself, I gamble that my health will be good and I take a high deductible plan with lower premiums. But, I do have savings if something bad happens. No problem, I can pay the out of pocket maximum.

If you don't have any savings to tap into, then you probably want to pay more per month for lower deductible and lower out of pocket maximum.

 

[jc42]

@glorydaz Plan 4
20k MAX cost OOP max +Prem
Plan 3
17,808$ cost OOP max+Prem
Plan 2
21,501$ cost OOP max+prem
Plan 1
20,772$ cost OOP max+prem

The best plan if you don’t think you might use healthcare that much but you want coverage in case something catastrophic happens. I would say go with plan 3 then stepping it upto plan 2.
If you really needed out of network coverage, go for plan two even though it is the highest cost you have out of network coverage and possibly consider plan one if you’re wanting out of network coverage